title: Assessment of the perfusion and morbidity of the buccal mucosal donor site for grafting of urethral strictures.
abstract: 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™ 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.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Germany. hoelzle@mkg.med.tum.de
authors.forename: Frank
authors.initials: F
authors.lastname: Hölzle
authors.forename: David A
authors.initials: DA
authors.lastname: Mitchell
authors.forename: Andrea
authors.initials: A
authors.lastname: Rau
authors.forename: Jüri
authors.initials: J
authors.lastname: Palisaar
authors.forename: Denys J
authors.initials: DJ
authors.lastname: Loeffelbein
authors.forename: Joachim
authors.initials: J
authors.lastname: Noldus
authors.forename: Anne
authors.initials: A
authors.lastname: Hoheisel
authors.forename: Thomas
authors.initials: T
authors.lastname: Mücke
authors.forename: Marco
authors.initials: M
authors.lastname: Kesting
authors.forename: Klaus-Dietrich
authors.initials: KD
authors.lastname: Wolff
mesh_terms: D006097:Granulation Tissue; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D009061:Mouth Mucosa / Q000098:blood supply* / Q000473:pathology / Q000637:transplantation*; D010092:Oximetry / Q000295:instrumentation; D010108:Oxyhemoglobins / Q000737:chemistry; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods; D013057:Spectrum Analysis; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000379:methods; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014945:Wound Healing
chemical_list: D010108:Oxyhemoglobins