Bolster dressing to support a full-thickness skin graft

The patient with a through-and-through defect of the nose suffers from a loss of skin, subcutaneous tissue, cartilage, and nasal lining. Repair of this defect is generally directed toward restoring the components of skin and lining. The forehead flap is a useful substitute for nasal skin. A full-thickness skin graft may be used to substitute for absent nasal mucosa and serve as a lining for the forehead flap, covering its deep surface and retarding wound contracture. In the case presented, firm contact was maintained between the forehead flap and its full-thickness graft lining using a bolster dressing of simple design. We believe this dressing discourages seroma and hematoma formation while maintaining contact between the graft and the vascularized flap bed.