DERMOFAT GRAFTS AND MYOCUTANEOUS FLAPS IN GENITAL RECONSTRUCTION: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.56238/levv16n54-020Keywords:
Genital Reconstruction, Surgical Flaps, Dermis, Reconstructive Surgical ProceduresAbstract
Introduction: Genital reconstruction plays a critical role in restoring form, function, and psychosocial well-being after trauma, infection, oncologic resection, or congenital malformation. Dermofat grafts and myocutaneous flaps have emerged as fundamental reconstructive strategies, offering volume restoration, vascularized coverage, and improved cosmetic outcomes. Despite their widespread use, significant variability exists in techniques, donor-site selection, and long-term functional results, warranting a systematic synthesis of current evidence.
Objective: The main objective of this systematic review was to evaluate the clinical effectiveness, complication rates, and patient-reported outcomes associated with dermofat grafts and myocutaneous flaps in genital reconstruction. Secondary objectives were to: (1) compare functional and aesthetic results between techniques; (2) analyze complication profiles and revision rates; (3) evaluate long-term outcomes and durability; (4) assess patient satisfaction and quality of life; and (5) identify gaps and future research priorities.
Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and ICTRP, covering publications from January 2015 to October 2025. Studies involving human participants undergoing genital reconstruction with dermofat grafts or myocutaneous flaps were included. Randomized controlled trials, cohort studies, case series, and systematic reviews were eligible. Two independent reviewers performed study selection, data extraction, and risk-of-bias assessment according to PRISMA 2020 guidelines. Certainty of evidence was appraised using GRADE.
Results and Discussion: A total of 18 studies met the inclusion criteria. Evidence indicates that dermofat grafts provide favorable aesthetic outcomes and satisfactory contour restoration, particularly in penile reconstruction and labial augmentation, whereas myocutaneous flaps offer robust vascularization and are preferred for large or composite defects. Most studies reported high patient satisfaction and acceptable complication rates, though donor-site morbidity remains a relevant concern. Heterogeneity in technique and outcome assessment limits direct comparisons across studies.
Conclusion: Both dermofat grafts and myocutaneous flaps are safe and effective options in genital reconstruction, with technique selection guided by defect complexity, patient anatomy, and surgeon expertise. Standardized outcome measures and multicenter prospective trials are needed to refine indications and optimize long-term results.
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