Abstract
BackgroundSkin engraftment of intraoral defects is known to be inconsistent due to mobility of the oral structure, uneven wounds, and accumulation of saliva under the skin graft. To improve the success rate of oral skin graft, we proposed a novel and simple dressing technique for intraoral skin graft to control saliva accumulation, in comparison with the conventional bolster dressing.MethodsWe retrospectively reviewed 31 patients reconstructed with skin graft in their intraoral defect. The patients were divided into two groups; conventional bolster group (n = 21) and modified bolster group (n = 10). In the modified bolster group, a polyvinyl alcohol sponge was designed to fit the skin graft and a suction drain was inserted with tagging suture to apply continuous suction. We analyzed the success rate, the size of the skin grafts and clinical variables of each method.ResultsThe overall success rate of oral skin graft was not different between the two groups (90.0 and 90.5%). However, partial necrosis in the engrafted skin was observed frequently in the control group (57.1% versus 20.0%). The relative engrafted area was significantly higher in the modified bolster group (55.0 ± 11.6% versus 23.0 ± 18.7%, p = 0.015). The duration of bolster dressing and the time to start an oral diet were shorter in the modified bolster group.ConclusionsOur modified method could be easily applied for removing saliva accumulation under a skin graft and for enhancing skin engraftment of an oral cavity wound.
Highlights
Skin engraftment of intraoral defects is known to be inconsistent due to mobility of the oral structure, uneven wounds, and accumulation of saliva under the skin graft
Different from other organs, an intraoral wound has some disadvantages in skin engraftment due to constant mobility of the oral structure, uneven wound bed, and accumulation of saliva between grafted skin and wound bed [6]
Many types of stents, such as simple cotton ball, resin molds, and foam pad have been used in a tie-over bolster technique to anchor the graft to the wound bed [10]
Summary
Skin engraftment of intraoral defects is known to be inconsistent due to mobility of the oral structure, uneven wounds, and accumulation of saliva under the skin graft. Skin graft is a useful method for repairing wound, for superficial defects that could not be closed primarily It is a simple and less time-consuming procedure compared to regional and free flaps. Different from other organs, an intraoral wound has some disadvantages in skin engraftment due to constant mobility of the oral structure, uneven wound bed, and accumulation of saliva between grafted skin and wound bed [6]. To overcome these disadvantages, various methods have been tried to secure intraoral skin graft for immobilization [7,8,9]. Many types of stents, such as simple cotton ball, resin molds, and foam pad have been used in a tie-over bolster technique to anchor the graft to the wound bed [10]
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