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Graft; derma-fat-fascia

CPT4 code

Name of the Procedure:

Graft; derma-fat-fascia

Summary

In layman's terms, a "graft; derma-fat-fascia" is a surgical procedure where skin, fat, and connective tissue (fascia) are transplanted from one part of the body to another. This is typically done to repair or reconstruct areas where tissue is missing or damaged.

Purpose

The procedure addresses issues involving tissue loss or defects. The goal is to restore the structure, function, and appearance of the affected area, providing both cosmetic and functional improvements.

Indications

This procedure is indicated for:

  • Extensive tissue damage due to trauma or injury.
  • Congenital defects or deformities.
  • Areas where previous surgeries or infections have caused tissue loss.
  • Patients requiring reconstructive surgery after tumor removal.

Preparation

  • Patients may need to fast for 6-8 hours before the procedure.
  • Certain medications may need to be adjusted or stopped as per doctor’s instructions.
  • Pre-operative tests like blood work or imaging studies may be required.

Procedure Description

  1. The patient is placed under general anesthesia.
  2. The surgeon identifies and marks the donor and recipient sites.
  3. An incision is made at the donor site to harvest a composite graft that includes the skin, fat, and fascia.
  4. The graft is carefully shaped and positioned at the recipient site.
  5. The graft is secured in place with sutures or staples.
  6. Both the donor and recipient sites are dressed appropriately.

Tools used include scalpels, forceps, sutures, and dressings. The patient is under general anesthesia during the procedure to ensure they are pain-free.

Duration

The procedure typically takes 2-4 hours, depending on the size and complexity of the graft.

Setting

The procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

  • Surgeon (performing the graft)
  • Surgical nurses (assisting during the procedure)
  • Anesthesiologist (administering and monitoring anesthesia)
  • Surgical technicians (providing support and tools)

Risks and Complications

  • Common risks: infection, bleeding, and scarring.
  • Rare risks: graft failure, hematoma, and adverse reactions to anesthesia. Complications can be managed with antibiotics, additional surgeries, or other medical interventions as needed.

Benefits

  • Restores appearance and function to the damaged area.
  • Can provide long-lasting results.
  • Immediate noticeable improvements post-procedure.

Recovery

  • Patients may need to stay in the hospital for a few days.
  • Regular follow-up appointments for wound care and to monitor healing.
  • Restrictions on physical activity for a few weeks.
  • Pain management with prescribed medications.

Alternatives

  • Skin grafts (without fat and fascia): simpler but may not provide the same structural support.
  • Flap surgery: using nearby tissue, avoiding the need for a distant donor site.
  • Synthetic or bioengineered grafts: less invasive but may not integrate as well as natural tissue.

Patient Experience

During the procedure, the patient is under anesthesia and will not feel anything. Post-procedure, the patient may experience discomfort, swelling, and mild pain at both the donor and recipient sites, which can be managed with pain medications and proper wound care.

Medical Policies and Guidelines for Graft; derma-fat-fascia

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