Redoable Tie-Over Dressing Using Multiple Loop Silk Threads

After skin grafting, to prevent hematoma or seroma collection at the graft site, a tie-over dressing has been commonly used. However, although the conventional tie-over dressing by suture is a useful method for securing a graft site, refixation is difficult when repeated tie-over dressing is needed. Therefore, we recommend a redoable tie-over dressing technique with multiple loops threads and connecting silk threads. After the raw surface of each of our cases was covered with a skin graft, multiple loop silk thread attached with nylon at the skin graft margin. We applied the ointment gauze and wet cotton/fluffy gauze over the skin graft, then fixed the dressing by connecting cross-counter multiple loop thread with connecting silk threads. When we opened the tie-over dressing by cutting the connecting silk threads, we repeated the tie-over dressing with the same method. The skin graft was taken successfully without hematoma or seroma collection or any other complications. In conclusion, we report a novel tie-over dressing enabling simple fixation of the dressing to maintain proper tension for wounds that require repetitive fixation. Further, with this reliable method, the skin grafts were well taken.

Soft Palate Reconstruction Using Bilateral Palatal Mucomuscular Flap and Pharyngeal Flap after Resection of Squamous Cell Carcinoma

Squamous cell carcinoma infrequently occurs at the soft palate. Although various methods can be used for reconstruction of soft palate defects that occur after resecting squamous cell carcinoma, it is difficult to obtain satisfactory results from the perspective of the functional restoration of the soft palate. A combination of bilateral palatal mucomuscular flap for the oral side and superiorly based posterior pharyngeal flap for the nasal side were performed on two patients who were diagnosed with squamous cell carcinoma of the soft palate in order to reconstruct the soft palate defects after surgical resection. After surgery, the patients were followed-up for a mean period of 11 months. The flaps were well maintained in both patients. The donor site defects were epithelialized and completely recovered. Additionally, no recurrence of the primary sites was shown. Slight hyponasality was observed in the voice assessments that were conducted 6 months after surgery. No food regurgitation or aspiration was observed in the swallowing tests. We used a combination of bilateral palatal mucomuscular flap and superiorly based posterior pharyngeal flap to reconstruct the soft palate defects that occurred after resecting the squamous cell carcinomas. We reduced the donor site complications and achieved functionally satisfactory outcomes.