Buccal Mucosa Graft Harvest in Children and Young Adults: Case Series and Harvest Technique

Buccal mucosa is a great choice for urethroplasty for urethral stricture repair because of ease of harvesting, pliability of the graft, and minimal donor site morbidity. These procedures are performed at our institution as a combined case with Pediatric Otolaryngology and Urology. Harvesting buccal mucosal grafts in younger patients is more technically challenging due to limited oral cavity access and smaller area available for tissue harvest, but is able to be performed safely and with limited morbidity with the addition of parotid duct cannulation and use of retraction sutures to the graft harvest technique. This retrospective case series reports harvest technique, outcomes, and complications of children and young adult males undergoing buccal or lower lip mucosal graft harvesting to repair congenital urethral strictures. Outcome measures were perioperative bleeding, trismus, pain, numbness, parotid duct injury and lip deformity. Six patients underwent nine harvest procedures. Technique modifications included application of anterior graft margin stay sutures to help stabilize the graft mucosa and cannulation of the parotid duct with lacrimal probes to avoid duct injury and to maximize graft size. Overall, buccal mucosal graft harvesting is a well-tolerated procedure with minimal complications using proper harvest technique.