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Allograft Infection in Phalloplasty – a model for comparison of 3 different allograft materials
Introduction: Allograft use has increased recently with the rising use of allograft materials in breast surgery. There is no data that compares the performance of the various allograft materials in this application, despite marketing efforts by the manufacturers to present one allograft material as superior to another. Phalloplasty is a procedure that uses allografts for penis girth augmentation. The author has had experience with the use of three different types of allografts for this procedure. Preparation of these grafts differs with each manufacturer. This allows for comparison of these materials in their performance with a single model.
Methods: 47 patients who underwent penis girth enhancement with allograft material were reviewed. All patients underwent circumferential grafting to the shaft of the penis at the level of Buck’s fascia. Graft materials included Alloderm® (N=9), Belladerm® (N=20), and Repriza® (N=21). Charts were reviewed for material type, presence and type of infection, wound exposure, and graft loss with attention to the type of allograft material that was used.
Results: Follow-up ranged from 1-120 months with an average of 11.25 months. Infection occurred in 20 of 47 patients (42%). Of these, graft exposure occurred in 17 patients (36%) while 3 patients (6%) sustained total graft loss. Graft exposure or loss occurred in 3 patients who had Alloderm®, 9 patients with Belladerm® and 8 patients with Repriza®. No patients with Alloderm® sustained graft loss, while 2 patients with Belladerm® and one patient with Repriza® sustained graft loss. There were no statistical differences among these graft types with regard to infection or graft loss.
Conclusion: Three different brands of allograft material were used in one surgical procedure and followed for their performance with regard to exposure and infection. In this model, there is no difference in the rate of infection in these materials despite their different methods of preparation.