"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.
Butler
Charles E
CE
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
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