Butler Charles E
Department of Plastic Surgery, The University of Texas, M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 443, Houston, Texas 77030-4009, USA.
Head Neck. 2002 Jul;24(7):705-9. doi: 10.1002/hed.10112.
Because of surface irregularities and continuous movement of the tongue, predictable immobilization of split-thickness skin grafts (STSGs) for tongue defects is difficult to achieve.
A novel composite, bilayer foam bolster was used to immobilize a STSG after reconstruction of more than 80% of the tongue mucosa after resection of a squamous cell carcinoma and extensive leukoplakia. Dorsal and ventral bolster components were placed over the STSG and affixed using transglossal, through-and-through sutures.
The composite foam bolster provided uniform compression along the highly irregular and mobile skin-grafted surface. Graft survival was excellent, and there were no complications.
The "tongue sandwich" bolster is quickly and easily fabricated, immobilizes the tongue in a fully expanded position, and provides excellent apposition of STSGs to highly irregular and vascular surfaces.
