Solomon Mark P, Komlo Caroline, Defrain Molly
Pennsylvania Hospital, Philadelphia, PA, USA.
Ann Plast Surg. 2013 Sep;71(3):297-9. doi: 10.1097/SAP.0b013e318281aece.
Allograft use has increased recently with the rising use of allograft materials in breast surgery. There are few data that compare 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. Preparation of these grafts differs with each manufacturer. We report our experience with 3 different types of allografts for this procedure. This allows for the comparison of these materials in their performance with a single model.
Forty-seven 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.
Follow-up ranged from 1 to 120 months with an average of 11.25 months. Infection, defined as an open wound with graft exposure, occurred in 20 (42%) of 47 patients. Of these, graft exposure only occurred in 17 (36%) patients, whereas 3 (6%) patients 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, whereas 2 patients with Belladerm and 1 patient with Repriza sustained graft loss. There were no statistical differences among these graft types with regard to infection or graft loss.
Three different brands of allograft material were used in 1 surgical procedure and followed up 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. Implications of this fact are discussed in the approach surgeons should consider when using these materials.
随着同种异体移植材料在乳房手术中的使用增加，同种异体移植的应用近来有所增多。尽管制造商在营销中努力表明一种同种异体移植材料优于另一种，但很少有数据比较各种同种异体移植材料在该应用中的性能。阴茎增粗术是一种使用同种异体移植来增加阴茎周长的手术。这些移植物的制备方法因制造商而异。我们报告了我们在该手术中使用3种不同类型同种异体移植物的经验。这使得能够在单一模型中比较这些材料的性能。
回顾了47例接受同种异体移植材料进行阴茎周长增大术的患者。所有患者均在Buck筋膜水平对阴茎体进行环形移植。移植材料包括AlloDerm（n = 9）、Belladerm（n = 20）和Repriza（n = 21）。查阅病历以了解材料类型、感染的存在和类型、伤口暴露情况以及移植物丢失情况，并关注所使用的同种异体移植材料类型。
随访时间为1至120个月，平均为11.25个月。47例患者中有20例（42%）发生感染，定义为伴有移植物暴露的开放性伤口。其中，仅17例（36%）患者出现移植物暴露，而3例（6%）患者移植物完全丢失。使用AlloDerm的患者中有3例发生移植物暴露或丢失，使用Belladerm的患者中有9例，使用Repriza的患者中有8例。使用AlloDerm的患者中无移植物丢失，而使用Belladerm的患者中有2例、使用Repriza的患者中有1例移植物丢失。这些移植物类型在感染或移植物丢失方面无统计学差异。
在1项外科手术中使用了3种不同品牌的同种异体移植材料，并对其暴露和感染方面的性能进行了随访。在该模型中，尽管这些材料的制备方法不同，但它们的感染率并无差异。本文讨论了这一事实对外科医生在使用这些材料时应考虑的方法的影响。
