Editorial Comment in Response to: Postoperative Oral Care Pathways are Not Required at the Time of Buccal Mucosa Harvest

In this study, the authors seek to streamline buccal graft urethroplasty further by reducing the burden of preoperative and postoperative care of the oral graft site for patients.1 As surgeons we all recognize that the more we tell patients to remember and do as apart of postoperative care, the less likely they are to remember to do it. In this study, the authors compare an oral prep and regimented postoperative oral care pathway (soft food for 2 days, high fiber diet, no alcohol for 24 hours, use of salt water rinses, and no tree nuts until incision was completely healed in conjunction with 1 of 3 mouth washes) to no prep or postoperative oral care. It should be noted that both surgeons in the study close their graft site, which is variable in the reconstructive community. Based on previously published data whether to close the graft site may not matter regarding postoperative complications, but when considering no oral care postoperatively, it may be relevant.2 This study includes a heterogenous patient population regarding oral hygiene and tobacco use, but the groups seem fairly well matched, and this is addressed in Table 1. One limitation is that care could have occurred outside the tertiary care center; however, the authors are to be commended for including not just emergency department visits and readmissions but also triage calls regarding potential graft site complications. In thinking about the study by Kurtzman et al3 regarding oral hygiene relating to buccal graft histology and outcomes of urethroplasty, I am left wondering if the conclusion here that complication rates remain low despite no preoperative oral prep or postoperative oral care would hold true universally, that is, without graft site closure and/or in the setting of poor dentition.