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• W2103229573 abstract "No AccessJournal of UrologyAdult Urology1 Mar 2014Prediction of Early and Late Complications after Oral Mucosal Graft Harvesting: Multivariable Analysis from a Cohort of 553 Consecutive Patients Guido Barbagli, Nicola Fossati, Salvatore Sansalone, Alessandro Larcher, Giuseppe Romano, Vincenzo Dell'Acqua, Giorgio Guazzoni, and Massimo Lazzeri Guido BarbagliGuido Barbagli Center for Reconstructive Urethral Surgery, Arezzo, Italy More articles by this author , Nicola FossatiNicola Fossati Department of Urology, San Raffaele Turro Hospital, Milan, Italy More articles by this author , Salvatore SansaloneSalvatore Sansalone Department of Experimental Medicine and Surgery, University of Tor Vergata, Rome, Italy More articles by this author , Alessandro LarcherAlessandro Larcher Department of Urology, San Raffaele Turro Hospital, Milan, Italy More articles by this author , Giuseppe RomanoGiuseppe Romano Center for Reconstructive Urethral Surgery, Arezzo, Italy More articles by this author , Vincenzo Dell'AcquaVincenzo Dell'Acqua Department of Urology, San Raffaele Turro Hospital, Milan, Italy More articles by this author , Giorgio GuazzoniGiorgio Guazzoni Department of Urology, San Raffaele Turro Hospital, Milan, Italy More articles by this author , and Massimo LazzeriMassimo Lazzeri Department of Urology, San Raffaele Turro Hospital, Milan, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.09.006AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigated the early and late complications after oral mucosal graft harvesting, and reported the independent predictors of outcome via multivariable analysis. Materials and Methods: We performed a retrospective descriptive study of 553 patients from whom an oral mucosa graft was harvested for urethroplasty from single or bilateral cheeks. Patients who underwent oral mucosa harvesting from the lip, the tongue or from the cheek and lip at the same time were excluded from analysis. The oral graft was harvested in an ovoid shape with closure of the wound. Postoperative early and late complications were investigated using a self-administered, nonvalidated, semiquantitative questionnaire. There were 6 questions on early complications, and 13 questions investigated late complications and patient satisfaction. Results: Descriptive statistics of categorical variables focused on frequencies and proportions. Univariable and multivariable analyses were used to predict early and late dissatisfaction of patients. Bleeding was reported in 3.4% of patients. Overall 53.2% of patients did not report any pain and 36.3% reported no swelling. Late complications analysis showed that 95.5% of patients declared that the surgical closure of the wound did not cause any difficulty in opening the mouth or problems with smiling (98.2%) and/or dry mouth (95.8%). Overall 98.2% of patients were satisfied with the procedure. Univariable and multivariable analyses revealed that bilateral graft harvesting was the only significant predictor of patient dissatisfaction (OR 2.85, p = 0.01 and OR 2.72, p = 0.02; respectively). Conclusions: Harvesting the oral mucosa ovoid graft from a single cheek with closure of the wound is a safe procedure with high rates of patient satisfaction. References 1 : The first oral mucosal graft urethroplasty was carried out in the 19th century: the pioneering experience of Kirill Sapezhko (1857-1928). Eur Urol2012; 62: 624. Google Scholar 2 : Re: Buccal mucosal grafts: lessons learned from an 8-year experience. J Urol2002; 168: 202. Link, Google Scholar 3 : The oral mucosa graft: a systematic review. J Urol2007; 178: 387. Link, Google Scholar 4 : Oral mucosa harvest: an overview of anatomic and biologic considerations. EAU-EBU Update Series2007; 5: 179. Google Scholar 5 : The morbidity of buccal mucosal graft harvest for urethroplasty and the effect of nonclosure of the graft harvest site on postoperative pain. J Urol2004; 172: 580. Link, Google Scholar 6 : Oral complications after buccal mucosal graft harvest for urethroplasty. BJU Int2004; 94: 867. Google Scholar 7 : Comparison of donor site intraoral morbidity after mucosal graft harvesting for urethral reconstruction. Urology2005; 66: 716. Google Scholar 8 : Morbidity associated with oral mucosa harvest for urological reconstruction: an overview. J Oral Maxillofac Surg2008; 66: 739. Google Scholar 9 : Effect of wound closure on buccal mucosal graft harvest site morbidity: results of a randomized prospective trial. Urology2012; 79: 443. Google Scholar 10 : Morbidity of oral mucosa graft harvesting from a single cheek. Eur Urol2010; 58: 33. Google Scholar 11 : Oral submucus fibrosis surgical treatment with CO2 laser. World Art ENT2010; 3. Google Scholar 12 : Postauricular skin as an alternative to oral mucosa for anterior onlay graft urethroplasty: a preliminary experience in patients with oral mucosa changes. Urology2009; 74: 345. Google Scholar 13 : Donor-site morbidity in buccal mucosa urethroplasty: lower lip or inner cheek?. BJU Int2005; 96: 619. Google Scholar 14 : Preliminary report on use of AlloDerm for closure of intraoral defects after buccal mucosal harvest. Urology2007; 69: 372. Google Scholar 15 : Donor site outcome after oral mucosa harvest for urethroplasty in children and adults. J Urol2008; 180: 2624. Link, Google Scholar 16 : Re: Rourke et al: Effect of wound closure on buccal mucosal graft harvest site morbidity: results of a randomized prospective trial (Urology 2012; 79: 443–448). Urology2012; 80: 741. Google Scholar 17 : Can reconstructive urethral surgery proceed without randomised controlled trial?. Eur Urol2008; 54: 709. Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byBarbagli G, Akbarov I, Heidenreich A, Zugor V, Olianas R, Aragona M, Romano G, Balsmeyer U, Fahlenkamp D, Rebmann U, Standhaft D and Lazzeri M (2018) Anterior Urethroplasty Using a New Tissue Engineered Oral Mucosa Graft: Surgical Techniques and OutcomesJournal of Urology, VOL. 200, NO. 2, (448-456), Online publication date: 1-Aug-2018.Steers W (2013) This Month in Adult UrologyJournal of Urology, VOL. 191, NO. 3, (571-572), Online publication date: 1-Mar-2014. Volume 191Issue 3March 2014Page: 688-693Supplementary Materials Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.Keywordsquestionnairescheekpostoperative complicationsmouth mucosaurethraMetricsAuthor Information Guido Barbagli Center for Reconstructive Urethral Surgery, Arezzo, Italy More articles by this author Nicola Fossati Department of Urology, San Raffaele Turro Hospital, Milan, Italy More articles by this author Salvatore Sansalone Department of Experimental Medicine and Surgery, University of Tor Vergata, Rome, Italy More articles by this author Alessandro Larcher Department of Urology, San Raffaele Turro Hospital, Milan, Italy More articles by this author Giuseppe Romano Center for Reconstructive Urethral Surgery, Arezzo, Italy More articles by this author Vincenzo Dell'Acqua Department of Urology, San Raffaele Turro Hospital, Milan, Italy More articles by this author Giorgio Guazzoni Department of Urology, San Raffaele Turro Hospital, Milan, Italy More articles by this author Massimo Lazzeri Department of Urology, San Raffaele Turro Hospital, Milan, Italy More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2103229573 title "Prediction of Early and Late Complications after Oral Mucosal Graft Harvesting: Multivariable Analysis from a Cohort of 553 Consecutive Patients" @default.
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