Assessment of the perfusion and morbidity of the buccal mucosal donor site for grafting of urethral strictures

Buccal mucosal grafting has become the gold standard for reconstruction of urethral strictures. The aim of this study was to investigate donor site morbidity with a unique emphasis on objective measurements of perfusion and oxygenation. Methods: In a prospective study 15 male patients with recurrent urethral strictures, underwent urethroplasty using an intraoral mucosal graft. Donor site was closed primarily (group 1) or left to granulation (group 2). Clinical examinations of recipient and donor sites, urograms and the modified SF-8 (TM) health questionnaire were carried out 1, 3 and 24 weeks postoperatively. Oxygenation and perfusion parameters of the donor site were measured by the O2C (oxygen-to-see) monitoring device - a combined technique of laser Doppler flowmetry and tissue spectroscopy. Results: No recurrence of strictures at recipient site or infections at either sites occurred. 24 weeks after operation, haemoglobin oxygenation (72.1 +/- 5.9%) and deep flow (177.2 Arbitrary Units (AU)) of the donor site were slightly, but not significantly, lower compared to the contralateral unoperated buccal mucosa (haemoglobin oxygenation: 75.4 +/- 5.2%, deep flow: 187.3 AU). Significant differences between the two groups of different wound healing could not be revealed. Conclusions: Using free mucosal grafts for urethroplasty is a simple and safe method in the interdisciplinary treatment of urethral strictures. Donor site morbidity within the first 3 weeks after operation is noticeable, but tolerable measured by a validated Quality of Life-tool. Six months after the operation, perfusion and oxygenation of the former graft harvest site are equal to the contralateral unoperated mucosa. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery.