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A Comparison of Two Fat Grafting Methods on Operating Room Efficiency and Costs
Allen Gabriel1, G Patrick Maxwell1, Leah Griffin1
1Drs Gabriel and Champaneria are plastic surgeons in private practice in Vancouver, WA. Ms Griffin is a Senior Manager of Biostatistics and Outcomes Research, Acelity, San Antonio, TX. Dr Maxwell is a plastic surgeon in private practice in Nashville, TN. Ms Parekh is a Global Health Economics Manager and Mr Macarios is a Vice President of Health Economics and Outcomes Research, Acelity, Bridgewater, NJ.
Background:
Centrifugation (Cf) is a common method of fat processing but may be time consuming, especially when processing large volumes.
Objectives:
To determine the effects on fat grafting time, volume efficiency, reoperations, and complication rates of Cf vs an autologous fat processing system (Rv) that incorporates fat harvesting and processing in a single unit.
Methods:
We performed a retrospective cohort study of consecutive patients who underwent autologous fat grafting during reconstructive breast surgery with Rv or Cf. Endpoints measured were volume of fat harvested (lipoaspirate) and volume injected after processing, time to complete processing, reoperations, and complications. A budget impact model was used to estimate cost of Rv vs Cf.
Results:
Ninety-eight patients underwent fat grafting with Rv, and 96 patients received Cf. Mean volumes of lipoaspirate (506.0 vs 126.1 mL) and fat injected (177.3 vs 79.2 mL) were significantly higher (P < .0001) in the Rv vs Cf group, respectively. Mean time to complete fat grafting was significantly shorter in the Rv vs Cf group (34.6 vs 90.1 minutes, respectively; P < .0001). Proportions of patients with nodule and cyst formation and/or who received reoperations were significantly less in the Rv vs Cf group. Based on these outcomes and an assumed per minute operating room cost, an average per patient cost savings of $2,870.08 was estimated with Rv vs Cf.
Conclusions:
Compared to Cf, the Rv fat processing system allowed for a larger volume of fat to be processed for injection and decreased operative time in these patients, potentially translating to cost savings. LEVEL OF EVIDENCE 3.
