Intraoral Split-Thickness Skin Grafts: A New Approach Using Vinyl Polysiloxane

Abstract

Multiple approaches for immobilizing skin grafts intraorally have been described in the literature. In 1975, Goshgarian and Miller described a parachute tent technique that secures intraoral skin grafts via ranscutaneous sutures. In 1981, Friedlander and Miler described a technique using eye patches and a denture soft liner, securing the split-thickness skin graft (STSG) to the cheek using transbuccal bolster sutures. Since then, many materials have been used, including foam, gauze, sutures, silicone, foam rubber pads, and eye patches, in addition to a myriad of different bolstering techniques. Typical problems with current methods include debris accumulation, graft mobility, lack of stent rigidity, cutaneous pressure sores from bolster sutures, and early graft contracture. Vinyl polysiloxane (VPS), also known as polyvinyl siloxane, is an addition silicone used extensively in dentistry for dental impressions, and its use has been reported in the literature as a temporary obturator for orocutaneous fistulas. The method decribed in this case report secures and protects the raft site intraorally, saves time intraoperatively, mainains the integrity of the graft, allows for early openng and mobilization, and is comfortable for the paient postoperatively. The purpose of this article is to ntroduce a technique using VPS to immobilize and rotect an STSG intraorally.