Septodermoplasty: Make It Easier

Abstract

Septodermoplasty (SDP) is a technique that presents a surgical option for the treatment of recalcitrant epistaxis from hereditary hemorrhagic telangiectasia. It involves the removal of affected nasal epithelium, replacing it with a split thickness skin graft (STSG). However, the inherent challenges with SDP are that owing to the floppy and unstable nature of the STSG, especially if simultaneously grafting the lateral nasal wall in addition to the septum and nasal floor, there is a risk of inadvertently stripping and displacing the STSG from its intended position. In this article we offer some techniques that utilize microdebrider for addressing mucosal lesions and fixate silastic sheet on floppy STSG as a scaffold to make it firm and easy to handle in order to hold the graft right in place.