Eur J Plast Surg (2002) 25:287 DOI 10.1007/s00238-002-0401-9 IDEAS AND INNOVAT IONS M. Jain · S. Kadam · M. Jagannathan · V. Dixit Use of the cheek blade of the Dingman mouth gag to aid elevation of the buccal cheek flap in cleft palate surgery Received: 25 April 2002 / Accepted: 3 July 2002 / Published online: 28 August 2002 © Springer-Verlag 2002 Abstract The use of additional mucosal bolstering of the flap in order to close the secondary defect without the nasal layer in cleft palate repairs is a commonly used tension. technique. The buccal cheek mucosal flap is a common Essentially this technique provides a stable platform donor site. This flap is normally elevated using the sur- for a mobile area of the cheek and frees the surgeon’s geon’s finger for counterpressure from the skin side of hand from the necessity of exerting counterpressure. The the cheek. A simple idea, using the cheek blade of the blade must in any case be removed prior to elevation of Dingman mouth gag externally, to serve as a stable plat- the flap; it is then placed externally. form to aid the elevation of this flap is presented. Keywords Buccal flap · Cleft palate · Dingman mouth gag After repair of the nasal layer and reorientation of the muscle the right cheek blade of the Dingman gag (usu- ally the preferred side for the right-handed surgeon) is reapplied on the skin aspect of the cheek, and pressure is applied to push the cheek inwards, between the jaws. The screw of the joint is then tightened to ensure that it does not slip. Two stay sutures are applied near the an- gle of the mouth, and traction is exerted outward, caus- ing further stretching of the cheek mucosa; this facili- tates easy elevation of the mucosal flap (Fig. 1). The blade can be loosened on completion of elevation of M. Jain · S. Kadam · M. Jagannathan ( ) · V. Dixit Department of Plastic Surgery, LTMG Hospital, Sion, Mumbai 400022, India Fig. 1 The blade of the Dingman mouth gag is shown placed on e-mail: email@example.com the external cheek, forming a stable platform for easy elevation of Fax: +91-22-4043141 the buccal mucosal cheek flap
European Journal of Plastic Surgery – Springer Journals
Published: Oct 28, 2002
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