"Tongue sandwich" bolster for skin graft immobilization.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Department of Plastic Surgery, The University of Texas, M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 443, Houston, Texas 77030-4009, USA. cbutler@mdanderson.org
Charles E
CE
Butler
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007103:Immobilization; D011140:Polyurethanes / Q000627:therapeutic use; D019736:Prostheses and Implants; D016038:Skin Transplantation / Q000379:methods*; D013536:Suture Techniques; D014062:Tongue Neoplasms / Q000601:surgery*
D011140:Polyurethanes; C028279:polyurethane foam