The Impact of Preoperative Oral Health on Buccal Mucosa Graft Histology

Kurtzman, Jane; Sukumar, Shyam; Pan, Sun-Ming; Mendonca, Shawn; Lai, Yue; Pagan, Carlos; Brandes, Steven B.

doi:10.1097/ju.0000000000001829

Cited by 18 publications

(10 citation statements)

References 23 publications

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“…Age was inversely related to the epithelial thickness of buccal grafts. This was consistent with findings that we previously published in a smaller cohort ( 9 ). Increasing CCI was associated with decreased MM layer thickness in CMGs, suggesting that cellular health of this layer could be impacted by a patient's medical milieu.…”

Section: Discussionsupporting

confidence: 94%

“…The protocol and technique for BMG harvest has been previously described and was standardized across all patients ( 9 ). An ovoid graft measuring approximately 5 × 2 cm was measured and marked on the inner cheek.…”

Section: Methodsmentioning

confidence: 99%

“…Certain patients may have specific relative or absolute contraindications to BMG use, such as: prior BMG harvest, surgery or radiotherapy for oral cancer treatment, active tobacco use or oral mucosal diseases. Poor oral health has also been shown to impact BMG histologic characteristics ( 9 ). Moreover, for many pan-urethral strictures or long obliterative strictures there may be insufficient total oral graft material for reconstruction ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

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Is colorectal mucosa a reasonable graft alternative to buccal grafts for urethroplasty?: A comparison of graft histology and stretch

et al. 2023

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Section: Discussionsupporting

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is colorectal mucosa a reasonable graft alternative to buccal grafts for urethroplasty?: A comparison of graft histology and stretch

et al. 2023

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“…In recent years, many clinical applications have used many techniques to treat urinary pouch strictures, such as lingual and buccal mucosal patches [ 6 , 7 ]. However, the limited availability of autologous tissue and the associated complications limit its application.…”

Section: Introductionmentioning

confidence: 99%

Clinical application of a double-modified sulfated bacterial cellulose scaffold material loaded with FGFR2-modified adipose-derived stem cells in urethral reconstruction

Zhu

Yang

et al. 2022

Stem Cell Res Ther

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Background Urethral stricture and reconstruction are one of the thorny difficult problems in the field of urology. The continuous development of tissue engineering and biomaterials has given new therapeutic thinking to this problem. Bacterial cellulose (BC) is an excellent biomaterial due to its accessibility and strong plasticity. Moreover, adipose-derived stem cells (ADSCs) could enhance their wound healing ability through directional modification. Methods First, we used physical drilling and sulfonation in this study to make BC more conducive to cell attachment and degradation. We tested the relevant mechanical properties of these materials. After that, we attached Fibroblast Growth Factor Receptor 2 (FGFR2)-modified ADSCs to the material to construct a urethra for tissue engineering. Afterward, we verified this finding in the male New Zealand rabbit model and carried out immunohistochemical and imaging examinations 1 and 3 months after the operation. At the same time, we detected the potential biological function of FGFR2 by bioinformatics and a cytokine chip. Results The results show that the composite has excellent repairability and that this ability is correlated with angiogenesis. The new composite in this study provides new insight and therapeutic methods for urethral reconstruction. The preliminary mechanism showed that FGFR2 could promote angiogenesis and tissue repair by promoting the secretion of Vascular Endothelial Growth Factor A (VEGFA) from ADSCs. Conclusions Double-modified sulfonated bacterial cellulose scaffolds combined with FGFR2-modified ADSCs provide new sight and treatments for patients with urethral strictures.

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“…According to Vandana et al [ 40 ], epithelium thickness is directly related to male gender and indirectly associated with age. Recently, Kurtzman et al [ 41 ] evaluated BMG histology, correlating it with preoperative oral health in a series of 51 patients. They evidenced that, as oral health worsened (scored by different questionnaires), average epithelial and lamina propria thickness are decreasing, as well as the delta stretch of the graft.…”

Section: Discussionmentioning

confidence: 99%

Histological Comparison of Buccal and Lingual Mucosa Grafts for Urethroplasty: Do They Share Tissue Structures and Vascular Supply?

Campos-Juanatey

Etxebarria

Hermosa

et al. 2022

JCM

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Comparable outcomes were published using a buccal mucosa graft (BMG) from the cheek and a lingual mucosa graft (LMG) from the sublingual area, for urethral augmentation or substitution. To date, no histological comparison between both grafts has been conducted. We histologically assessed BMG and LMG harvested during urethral surgeries, aiming to compare graft properties and vascular support. We conducted a prospective single cohort study, including oral mucosa urethroplasty patients. During surgery, graft dimensions and donor sites were collected, and a 0.5 × 0.5 cm sample was obtained from the prepared graft. Formalin-fixed paraffin-embedded samples were sliced at 4 micrometres (µm) and hematoxylin-eosin stained. Using a telepathology tool, all slides were digitalized and measured from 10× to 40× magnification. In each graft, global and individual layers thicknesses were assessed, including vascular density and area. Descriptive and comparative (parametrical and non-parametrical) statistical analysis occurred. We collected 57 grafts during 33 urethroplasties, with 30 BMG and 22 LMG, finally, included. The mean age was 56.6 (SD 15.2) years, and the mean graft length was 5.8 (SD 1.7) cm and the width was 1.7 (SD 0.4) cm. The median graft thickness was 1598.9 (IQR 1200–2100) µm, the mean epithelium layer was 510.2 (SD 223.7) µm, the median submucosa was 654 (IQR 378–943) µm. the median muscular was 477.6 (IQR 286–772) µm, the median vascular area was 5% (IQR 5–10), and the median adipose tissue area was 5% (IQR 0–20). LMG were significantly longer and narrower than BMG. Total graft thickness was similar between LMG and BMG, but the epithelium and submucosa layers were significantly thinner in LMG. The muscular layer was significantly thicker in LMG. Vascular density and vascular areas were not significantly different between both types of grafts. LMG showed significantly less adipose tissue compared with BMG. Our findings show LMG and BMG for urethroplasty surgeries share the same thickness and blood supply, despite having significantly different graft sizes as well as mucosal and submucosal layers thickness.

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The Impact of Preoperative Oral Health on Buccal Mucosa Graft Histology

Cited by 18 publications

References 23 publications

Is colorectal mucosa a reasonable graft alternative to buccal grafts for urethroplasty?: A comparison of graft histology and stretch

Is colorectal mucosa a reasonable graft alternative to buccal grafts for urethroplasty?: A comparison of graft histology and stretch

Clinical application of a double-modified sulfated bacterial cellulose scaffold material loaded with FGFR2-modified adipose-derived stem cells in urethral reconstruction

Histological Comparison of Buccal and Lingual Mucosa Grafts for Urethroplasty: Do They Share Tissue Structures and Vascular Supply?

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