Autologous Fat Grafting Versus Alloplastic Materials in Post-Traumatic Urogenital Reconstruction

TL;DR

This study compares autologous fat grafting and alloplastic materials for urogenital reconstruction after trauma, finding that fat grafting leads to better outcomes with fewer complications.

Contribution

The study provides a comparative analysis of autologous fat grafting and alloplastic materials in post-traumatic urogenital reconstruction, highlighting clinical and aesthetic advantages.

Findings

Autologous fat grafting had shorter surgical times and hospital stays compared to alloplastic materials.

Fat grafting resulted in significantly lower complication rates, including infection, extrusion, and fibrosis.

Patients who received autologous fat grafting reported higher aesthetic scores and satisfaction levels at 12 months.

Abstract

Background: Traumatic soft tissue injuries to the urogenital area need reconstructive procedures that minimize complications while restoring both shape and function.

Objective: To compare the reconstructive outcomes of autologous fat grafting versus alloplastic materials in the repair of post-traumatic urogenital soft tissue defects with respect to complication rates, aesthetic outcomes, and patient-reported satisfaction in a collaborative plastic surgery-urology clinical setting.

Methodology: This was a descriptive, multicenter observational study conducted from November 2022 to October 2024 at Shifa International Hospitals, Islamabad, along with Khyber Teaching Hospital, Peshawar, and Hayatabad Medical Complex, Peshawar. Out of 204 patients with post-traumatic urogenital abnormalities who were at least 18 years old, 106 had autologous fat grafting, and 98 had alloplastic repair. At six and 12 months, prospective data were gathered on demographics, injury features, surgical parameters, postoperative complications, cosmetic results (as judged by a panel of blinded people), and patient satisfaction (5-point Likert scale). IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 26. Armonk, NY: IBM Corp. was used for statistical analysis, which includes chi-square, t-tests, and multivariable regression.

Results: Mean surgical time was shorter in the fat grafting group (92.4 ± 18.1 min vs. 103.7 ± 20.9 min, p=0.002), with reduced hospital stay (1.8 ± 0.6 vs. 2.4 ± 1.1 days, p=0.001). Complication rates were significantly lower for fat grafting: infection in 5/106 patients (4.72%) vs. 14/98 (14.29%), p=0.018; extrusion in 0/106 (0%) vs. 9/98 (9.18%), p=0.003; fibrosis in 4/106 (3.77%) vs. 12/98 (12.24%), p=0.021. Excellent aesthetic scores at 12 months were achieved in 61/106 patients (57.55%) vs. 31/98 (31.63%), p=0.001, while very high satisfaction was reported by 58/106 (54.72%) vs. 29/98 (29.59%), p=0.001.

Conclusion: Autologous fat grafting yields superior functional and aesthetic outcomes with fewer complications compared to alloplastic materials in post-traumatic urogenital reconstruction.