title: Healing septal perforations by secondary intention using acellular dermis as a bioscaffold.
abstract: OBJECTIVE
  Several techniques are described in the literature for nasal septal perforation repair. Most of these involve interposition grafts in conjunction with local pedicled mucosal flaps. The following article describes our experience using acellular dermis as a bioscaffold to support the regrowth of nasal septal mucosa by secondary intention.
  
  
  METHODS
  Retrospective chart review of all patients who underwent repair of nasal septal perforations by the senior author using acellular dermis placed between the 2 sides of the perforation and covered with silastic splints to allow for mucosalization.
  
  
  RESULTS
  Thirteen patients underwent nasal septal perforation repair using this technique. All perforations repaired were under 2 cm in greatest dimension. Two-thirds of patients had complete closure of the perforation upon initial use of bioscaffolding technique. The remaining third achieved near-total closure with bioscaffolding technique and were able to be completely closed with a single additional procedure.
  
  
  CONCLUSIONS
  Acellular dermis offers an alternative to most currently described complex flaps. The method can be used in patients with defects less than 2 cm, but initial data suggest caution when using in those with wound healing impediments. This technique is also an excellent choice for patients with multiple small septal perforations.
authors.affiliation: Department of Otorhinolaryngology, Division of Facial Plastic Surgery, Mayo Clinic, Rochester, MN, USA.
authors.forename: Ayushman
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Otorhinolaryngology, Division of Facial Plastic Surgery, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Janus
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Henry R
authors.initials: HR
authors.lastname: Diggelmann
authors.affiliation: Department of Otorhinolaryngology, Division of Facial Plastic Surgery, Mayo Clinic, Rochester, MN, USA Hamilton.Grant@mayo.edu.
authors.forename: Grant S
authors.initials: GS
authors.lastname: Hamilton
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D004129:Dimethylpolysiloxanes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061270:Nasal Septal Perforation / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D004129:Dimethylpolysiloxanes; C013830:baysilon
keywords: acellular dermis; interposition graft; septal perforation; silastic splint