Postoperative pain and morbidity at the donor site after palatal soft tissue harvesting: a systematic review

This systematic review aims to evaluate the nature of postoperative pain and donor site morbidity following palatal soft tissue harvesting procedures, utilizing various wound dressings at the donor site.

A comprehensive search of five electronic databases and the grey literature was conducted of studies to June 2025, examining postoperative pain and morbidity following palatal graft harvesting. Eligible studies reported pain outcomes using Visual Analogue Scale (VAS) scores and assessed additional morbidity parameters. Risk of bias in randomized studies was assessed using the RoB 2.0 tool. Data on VAS scores were extracted for baseline and postoperative days 1, 3, 5, and 7. Donor site complications and morbidities were analyzed across various wound management approaches.

Sixty-eight studies met the inclusion criteria, of which thirty-eight reported self-reported pain scores using the VAS, presented as mean and standard deviation. Patient-reported outcomes, including quality of life assessments, were commonly used to evaluate broader postoperative impacts. Additional morbidities reported included bleeding, burning sensations, altered sensory perception, and changes in feeding behavior.

Postoperative pain is most pronounced within the first three days following surgery, with progressive reduction over time. The application of wound dressings or physical barriers can effectively reduce pain, although outcomes vary depending on the type of intervention used. Other commonly reported complications include bleeding, burning sensations, altered sensation, and changes in feeding behavior.