title: Prediction of early and late complications after oral mucosal graft harvesting: multivariable analysis from a cohort of 553 consecutive patients.
abstract: OBJECTIVE
  We investigated the early and late complications after oral mucosal graft harvesting, and reported the independent predictors of outcome via multivariable analysis.
  
  
  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.
authors.affiliation: Center for Reconstructive Urethral Surgery, Arezzo, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Barbagli
authors.affiliation: Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Fossati
authors.affiliation: Department of Experimental Medicine and Surgery, University of Tor Vergata, Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Sansalone
authors.affiliation: Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Larcher
authors.affiliation: Center for Reconstructive Urethral Surgery, Arezzo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Romano
authors.affiliation: Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Dell'Acqua
authors.affiliation: Department of Urology, San Raffaele Turro Hospital, Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Guazzoni
authors.affiliation: Department of Urology, San Raffaele Turro Hospital, Milan, Italy. Electronic address: lazzeri.maximus@gmail.com.
authors.forename: Massimo
authors.initials: M
authors.lastname: Lazzeri
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D020858:Tissue and Organ Harvesting / Q000379:methods*; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*
keywords: cheek; mouth mucosa; postoperative complications; questionnaires; urethra