Name of the Procedure:

Split-thickness Autograft, Trunk, Arms, Legs (First 100 sq cm or less, or 1% of Body Area of Infants and Children; Excluding Code 15050)

Summary

A split-thickness autograft involves transferring a thin layer of healthy skin from one part of the patient's body (donor site) to another area that has been damaged (recipient site). It is commonly performed on the trunk, arms, or legs and is often used for infants and children with small skin defects.

Purpose

This procedure is performed to cover wounds that cannot heal on their own, such as those resulting from burns, trauma, or surgical removal of diseased tissue. The expected outcome is improved wound healing and prevention of infection, leading to restored integrity of the skin.

Indications

• Deep burns
• Traumatic skin loss
• Surgical removal of skin lesions
• Chronic non-healing ulcers
• Congenital skin defects in infants and children

Preparation

• Patients may need to fast for several hours prior to the procedure.
• Medication adjustments might be necessary, particularly if the patient is on blood thinners.
• Pre-operative blood tests and a thorough physical examination may be required.
• Parental consent is obtained for infants and children.

Procedure Description

1. Administration of local anesthesia or general anesthesia.
2. Harvesting a thin layer of skin from a healthy area (usually the thigh) using a special instrument (dermatome).
3. The harvested skin is carefully placed over the prepared recipient site.
4. The graft is secured with stitches, staples, or surgical glue.
5. Both the donor and recipient sites are covered with sterile dressings.

Duration

The procedure typically takes 1 to 2 hours, depending on the size and complexity of the graft.

Setting

The procedure is usually performed in a hospital's surgical suite or a specialized outpatient surgical center.

Personnel

The team typically includes a surgeon, a surgical nurse, an anesthesiologist, and support staff.

Risks and Complications

• Infection
• Bleeding or hematoma
• Graft failure or rejection
• Scarring
• Donor site pain or infection
• Fluid imbalance in infants

Benefits

• Enhanced wound healing
• Reduced risk of infection
• Improved functional and cosmetic outcomes
• Quick restoration of skin integrity

Recovery

• Patients may need to stay in the hospital for a few days for monitoring.
• Post-operative care includes wound care instructions, pain management, and possibly antibiotics to prevent infection.
• Recovery time varies but generally spans several weeks for both graft and donor sites.
• Regular follow-up appointments to monitor healing and address any complications.

Alternatives

• Full-thickness skin grafts: Suitable for smaller, more specialized areas but involve a thicker piece of skin.
• Synthetic grafts or dermal substitutes: An option when donor skin is limited.
• Wound dressings and conservative care: Less invasive but may not be suitable for large or deep wounds.

Patient Experience

Patients might feel pain or discomfort at both the graft and donor sites, which can be managed with prescribed pain medications. Initial movements might be restricted to ensure proper graft adherence, and physical therapy may be recommended to regain full function.

Infants and children will require special attention to ensure they are comfortable and stress-free during recovery, including distraction techniques and age-appropriate pain management strategies.