Usefulness of Nasal Splints ( $Aquaplast^{\circledR}$ ) for Securing Full Thickness Skin Graft (FTSG)

Background: For securing FTSG, bolus tie-over dressing is a universally accepted method, but it has some definite disadvantages. For example, bulky dressing inhibits the drainage from graft bed and can lead to maceration by occlusion. Time and effort is necessary to secure dressing and the help of an assistant is also mandatory to tie the suture much easier. Objectives: In an attempt to find a better dressing material, we evaluated the usefulness of thermoplastic nasal splints () for securing graft in FTSG reconstruction. Methods: Thirteen patients with surgical defects following tumor excision from the nose(9 patients), forehead(1), lip(1), hand(1), shin(1) ranging from 12mm to 40mm in the largest diameter were reconstructed with a FTSG. For securing FTSG, a heat-moldable nasal splint was heated, contoured in place over sutured graft on recipient area with/without suture of the splint with skin. Results: All of the 13 FTSG secured with nasal splints showed a good take with a satisfactory cosmetic results. Except hypertrophic scars in 4 patients, which were not significant and improved with several times intralesional injection of triamcinolone, there were no other complications. Conclusion: We have found a heat-moldable nasal splint to be useful material to secure FTSG, especially for the complex contoured area such as nose or ear. This technique saves time and effort and there is no need of an assistant.