Postoperative Oral Care Pathways Are Not Required at the Time of Buccal Mucosa Harvest

Abstract

Purpose: For patients undergoing urethroplasty with buccal mucosa grafting, the impact of oral care pathways on infection and pain control remains unstudied. We hypothesize that the elimination of dietary restrictions and mouthwash regimens from the oral care pathway would not alter the rate of donor site complications. Materials and Methods: One hundred urethroplasty cases using buccal mucosa were retrospectively reviewed for donor site and perineal wound complications. No preoperative or intraoperative antibiotic oral cleanses were used in any case. Records were categorized by use of postoperative dietary restrictions and mouthwash regimens. Graft harvest size, preexisting oral issues, baseline comorbidities, dental assessments, perioperative antibiotics, and postoperative pain control regimens were accounted for. Results: Forty patients were included in the oral care pathway and 60 in the nonoral care pathway. Baseline demographics, dental assessment, and graft harvest details were similar between groups. There were no cases of graft site infection, with a median follow-up of 226 days. All graft site issues resolved in 3 to 4 weeks or less. Perineal wound infections for oral care pathway 2 (5%), and no oral care pathway 4 (6.7%), P = .6. Urinary tract infections for oral care pathway 7 (17.5%), and no oral care pathway 2 (3.3%), P = .027. Conclusions: Postoperative oral complications remain low without the use of oral cleanses, dietary restrictions, or mouthwash regimens. Routine use of donor site care pathways is likely unnecessary in this patient population.