(283) USE OF DECELLULARIZED CADAVERIC DERMAL ALLOGRAFT FOR REVISIONS FOLLOWING GENDER-AFFIRMING GENITAL SURGERY

Abstract Introduction Gender-affirming vaginoplasty is a complex procedure. Approximately one-third of cases require revisions after penile inversion vaginoplasty (PIV) due to functional and/or cosmetic concerns. Objective We aim to describe our experience using a cadaveric decellularized dermal allograft (DDA, DermaPure®;) for PIV revisions. Methods We performed a retrospective review of patients who required revision after PIV between October 2020 and October 2023. In our cohort of 19 vaginoplasty revisions, 6 were performed using DDA. We reviewed 5 patients who had adequate follow-up data. Patient characteristics are summarized in Table 1. Results The interval between PIV and revision surgery ranged between 3-217 (118.4 mean, SD+/-77.0) weeks. Indications for revisions were neovaginal stenosis, wound dehiscence, or graft loss. Surfaces grafted with DDA were treated with an antiseptic solution. The packing and urinary catheter were removed in 5 days. At this time point, neovaginal self-dilation protocol (TID, 15 minutes/session) was initiated. Signs of graft take and reepithelization were noted two weeks after DDA application in all patients who remained compliant with vaginal dilation at a mean follow-up of 27.2 (SD +/- 12.7) weeks. No allograft-related side effects were encountered. The outcomes of vaginoplasty revision are summarized in Table 2. Conclusions Grafting with DDA is a viable option for revisions following PIV and facilitates wound healing and cosmesis with minimal postoperative wound care. Disclosure No.