A Comment on Application of Hand Towel Drape over Dingman Mouth Gag

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Arch Craniofac Surg. 2015;16(2):102-102
Publication date (electronic) : 2015 August 11
doi : https://doi.org/10.7181/acfs.2015.16.2.102
Department of Plastic Surgery, Inha University School of Medicine, Incheon, Korea.
Correspondence: Kun Hwang. Department of Plastic Surgery, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea. jokerhg@inha.ac.kr
Received 2015 May 04; Revised 2015 June 25; Accepted 2015 July 15.

To the Editor

I have read with great interest the article entitled, "Application of Hand Towel Drape over Dingman Mouth Gag," by Choi and Park (Arch Craniofac Surg 2015;16:29-30) [1] and wish to share a comment. In the paper, the authors describe the usage of a towel drape over the mouth gag site. In Figs. 1 and 2, the towel covers the two lateral cheek retractors, tongue blades, and most of the upper and lower springs.

While the authors state that this towel prevents suture material from being caught in the gag, I am afraid this precisely defeats the very purpose of the spring coils, whose design it is to hold sutures in place until they are ready to be tied. The idea of suture-indexing spring coils was rst adopted to mouth gag by Professor Kilner at Oxford prior to World War II. I would leave this comment with the quotation of someone who personally knew both Drs. Kilner and Dingman-Dr. Millard Jr.

He wrote "One of the most disciplined aspect of the Kilner's surgery was his suturing. He would place an entire row of sutures for one layer and hang them in an orderly array on the spring coil on his gag. Then he would tie them all and cut the ends before placing the next entire row of stitches" [23].

From this reason, it would be wise think twice before using this "Peeping Tom like Hole."


No potential conflict of interest relevant to this article was reported.


1. Choi KB, Park MC. Application of hand towel drape over Dingman mouth gag. Arch Craniofac Surg 2015;16:29–30.
2. Millard DR Jr. Cleft craft: the evolution of its surgery. III. Alveolar and palatal deformities Boston: Little Brown; 1980.
3. Kilner TP. Cleft lip and palate repair technique. St Thomas Hosp Rep 1937;2:127–140.

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