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On the whole, spontaneous granulation or laissez-faire
is not recommended except for very small wound.
Advantages:
-
the excision margins are not distorted and therefore
useful in confirming complete excision of a malignant tumours such as malignant
melanaoma or sebaceous cell carcinoma (in which frozen section and Mohs'
technique have limitation in confirming complete excision)
Disadvantages:
-
delayed healing
-
increased contracture of the scar
-
increased distortion of the surrounding tissue
Spontaneous granulation is most useful in the medial canthal
region. This is because in this region, contraction occurs in a centripetal
direction and tension is distributed at the wound perimeter. The result
is less distortion of the lid and the surrounding structure.
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