Healing of Donor-site Buccal Mucosa Urethroplasty

A 25-year-old man with a history of complex urethral stricture disease, who underwent dorsal-onlay urethroplasty utilizing buccal mucosal graft from the left cheek, for 1.3 cm proximal bulbar urethral stricture. The buccal wound is closed as typically done in our institution(1), closing the anterior half of the wound with interrupted 4-0 chromic sutures, and leaving the posterior half of the wound to heal by secondary intention in order to drain any potential hematoma. The operation was uneventful, and the urethral catheter was removed at 3 weeks post-operatively. He is voiding well, and the graft donor site healed well with no issues. Interestingly, during the first month of the post-operative period, the patient took daily pictures for the healing process of the graft donor site. There is controversy as to whether to close the donor site wound or not, with a prospective study(2) and 2 randomized controlled trials (RCTs)(3, 4) showing benefit for non-closure in terms of less pain and earlier return to diet, while 1 RCT(5) showed no difference between the 2 groups. This provided a unique opportunity for up-close examination of the donor site healing process.