CC BY-NC 4.0 · Arch Plast Surg 2021; 48(02): 208-212
DOI: 10.5999/aps.2020.00843
Pediatric/Craniomaxillofacial/Head & Neck
Original Article

Early wound healing of the hard-palate mucosal harvest site using artificial dermis fixation by a transparent plate

Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku, Japan
,
Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
,
Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Shinjuku, Japan
,
Tomohiro Yamauchi
Dentistry/Oral Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Japan
› Author Affiliations
This study was supported by a research fund from Tokyo Dental College. This article was presented at the International Confederation for Plastic, Reconstructive and Aesthetic Surgery/Asian Pacific Section (IPRAS/APS) on October 8, 2009, in Tokyo, Japan.

Background There are currently no guidelines for the postoperative wound management of the hard-palate donor site in cases involving mucosal harvesting. This study describes our experiences with the use of an artificial dermis for early epithelialization and transparent plate fixation in cases involving hard-palate mucosal harvesting.

Methods A transparent palatal plate was custom-fabricated using a thermoplastic resin board. After mucosal harvesting, an alginic acid-containing wound dressing (Sorbsan) was applied to the donor site, which was then covered with the plate. After confirming hemostasis, the dressing was changed to artificial dermis a few days later, and the plate was fixed to the artificial dermis. The size of the mucosal defect ranged from 8×25 to 20×40 mm.

Results Plate fixation was adequate, with no postoperative slippage or infection of the artificial dermis. There was no pain at the harvest site, but a slight sense of incongruity during eating was reported. Although the fabrication and application of the palatal plate required extra steps before and after harvesting, the combination of the artificial dermis and palatal plate was found to be very useful for protecting the mucosal harvest site, and resulted in decreased pain and earlier epithelialization.

Conclusions The combination of artificial dermis and a transparent palatal plate for wound management at the hard-palate mucosal donor site resolved some of the limitations of conventional methods.



Publication History

Received: 11 May 2020

Accepted: 03 November 2020

Article published online:
07 March 2022

© 2021. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • REFERENCES

  • 1 Beatty RL, Harris G, Bauman GR. et al. Intraoral palatal mucosal graft harvest. Ophthalmic Plast Reconstr Surg 1993; 9: 120-4
  • 2 Holck DE, Foster JA, Dutton JJ. et al. Hard palate mucosal grafts in the treatment of the contracted socket. Ophthalmic Plast Reconstr Surg 1999; 15: 202-9
  • 3 Nakajima T, Yoshimura Y. One-stage reconstruction of full-thickness lower eyelid defects using a subcutaneous pedicle flap lined by a palatal mucosal graft. Br J Plast Surg 1996; 49: 183-6
  • 4 Ito O, Suzuki S, Park S. et al. Eyelid reconstruction using a hard palate mucoperiosteal graft combined with a V-Y subcutaneously pedicled flap. Br J Plast Surg 2001; 54: 106-11
  • 5 Henderson HW, Collin JR. Mucous membrane grafting. Dev Ophthalmol 2008; 41: 230-42
  • 6 Swamy BN, Benger R, Taylor S. Cicatricial entropion repair with hard palate mucous membrane graft: surgical technique and outcomes. Clin Exp Ophthalmol 2008; 36: 348-52
  • 7 Cheng JX, Zuo L, Huang XY. et al. Extensive full-thickness eyelid reconstruction with rotation flaps through “subcutaneous tunnel” and palatal mucosal grafts. Int J Ophthalmol 2015; 8: 794-9
  • 8 Shi Y, Zhou X, Yu J. et al. Reconstruction of full-thickness eyelid defects following malignant tumor excision: the retroauricular flap and palatal mucosal graft. J Craniofac Surg 2016; 27: 612-4
  • 9 Kitazawa T, Shiba M. Closure of a tracheocutaneous fistula with a local turnover flap combined with pregrafted palatal mucosa: a case report. Eplasty 2016; 16: e30
  • 10 Hatoko M, Kuwahara M, Tanaka A. et al. Correction of a posttraumatic nasal deformity using a hard palate mucosa graft. Aesthetic Plast Surg 2000; 24: 34-8