A boy was bit by a snake on the shin and the bite developed into a large abscess with significant loss of tissue. As the healing began, about 75% of the anterior tibia was exposed. The infection was now gone, but now the problem was healing an exposed bone.
As wounds heal, granulation tissue covers the wound. Colloquially, it is called “proud flesh.”
One way to get the bone covered with granulation tissue is to drill holes down into the marrow. This allows granulation tissue to “spring up” from the marrow and eventually spread out to cover the bone. In the series of photos below, you can see how the wound healed after bone drilling was done.
Once the bone is covered with granulation tissue, skin grafts are often applied to help the wound to heal faster.