STANDARD BUCCAL MUCOSA HARVESTING FOR URETHRAL RECONSTRUCTION
Introduction
The video shows step by step the correct technique for buccal mucosa harvesting from the cheek, for urethral reconstruction.
Materials and Methods
A Kilner-Doughty retractor guarantees an optimal access to the oral cavity,allows to perform a simple buccal mucosa harvesting by a single operator, and to work with an oral-tracheal intubation in the event a nasal-tracheal intubarion is difficult.
The right inner cheek is augmented by means of three traction stitches by the labial corner
We identify the Stenone's duct.
Keeping a 1 cm distance from the Stenone duct and from the labial corner, we delimit the harvesting area creating an oval shape to facilitate the subsequent suture of the oral gap.
We perform an infiltration of the cheek with adrenalin diluited 1:200.000 in order to reduce bleeding during the harvestin process.
The demarcated line is incised with the scalpel.
The buccal mucosa is removed with pointed scissors which help to find the décollement plane between the mucosa and the muscular plane. The hemosasis of the harvesting area is performed with the bipolar cauterium. The donor site is sutured with Vycril 4/0 semicontinuous stitches.
Results
This technique allows buccal mucosa up to a maximum of 6-7 cm in length and 2-3 cm in width..
Donor site complications have never occurred.
Conclusions
This is the standard technique to perform a large, simple and safe buccal mucosa harvesting.
