title: Closure versus nonclosure of buccal mucosal graft harvest site: A prospective randomized study on post operative morbidity.
abstract: OBJECTIVE
  To prospectively compare the postoperative morbidity of closure versus non closure of the buccal mucosal graft (BMG) harvest site.
  
  
  METHODS
  Patients who underwent BMG harvest for urethroplasty were randomized into 2 groups; in group 1 donor site was closed and in group 2 it was left open. Self made questionnaires were used to assess post-operative pain, limitation to mouth opening, loss of sensation at graft site. The time to resumption of liquid and solid diet were also noted.
  
  
  RESULTS
  Fifty patients were studied, 25 in each group from July 2003 to July 2005. BMG was harvested from single cheek in most of the patients. Mean post operative pain score was 4.20 and 3.08 at day 1 in group 1 and group 2, respectively (P < 0.05). Return to oral intake in terms of liquid and solid diet was comparable between the groups. Difficulty with mouth opening was maximal during the first week with no difference among the two groups. Two patients in group 1 and one in group 2 had persistent peri-oral numbness at 6 months. None of the patients in both the groups had changes in salivation or retention cysts.
  
  
  CONCLUSIONS
  Pain appears to be worse in the immediate post operative period with suturing of the harvest site. There is no difference in long term morbidity whether the graft site is closed or left open. It may be best to leave buccal mucosa harvest sites unsutured.
authors.affiliation: Department of Urology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli Road, Lucknow, India.
authors.forename: K
authors.initials: K
authors.lastname: Muruganandam
authors.forename: Deepak
authors.initials: D
authors.lastname: Dubey
authors.forename: Anil Kumar
authors.initials: AK
authors.lastname: Gulia
authors.forename: Anil
authors.initials: A
authors.lastname: Mandhani
authors.forename: Aneesh
authors.initials: A
authors.lastname: Srivastava
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kapoor
authors.forename: Anant
authors.initials: A
authors.lastname: Kumar