Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
CPT4 code
Name of the Procedure:
Epidermal Autograft, Trunk, Arms, Legs; First 100 sq cm or less, or 1% of Body Area of Infants and Children
Summary
An epidermal autograft is a medical procedure where healthy skin from one area of the body is transplanted to a site that has been damaged by injury or disease. This specific procedure involves removing a small section of the epidermis, usually less than 100 square centimeters or 1% of the body area of infants and children, from areas such as the trunk, arms, or legs.
Purpose
The procedure is performed to cover and heal areas of the skin that have been severely damaged by burns, trauma, infections, or certain dermatological conditions. The main goal is to promote healing, prevent infection, and improve the appearance and function of the affected skin.
Indications
- Severe burns
- Traumatic skin injuries
- Skin infections leading to necrosis
- Congenital skin defects
- Large, non-healing wounds or ulcers The procedure is particularly appropriate for patients who have enough healthy skin to harvest and when other simpler wound-care techniques are not effective.
Preparation
- Patients may need to fast for a few hours before the procedure if general anesthesia is required.
- Avoidance of certain medications, such as blood thinners, as advised by the doctor.
- Laboratory tests to assess overall health, such as blood tests and possibly imaging studies.
- Discussion of medical history and any allergies with the healthcare team.
Procedure Description
- Anesthesia: Local or general anesthesia will be administered depending on the extent of the graft and the patient’s age.
- Donor Site Preparation: A healthy section of skin, typically from a less visible part of the body, will be cleaned and sterilized.
- Skin Harvesting: A dermatome (a special surgical tool) will be used to remove the top layers of skin (epidermis and possibly part of the dermis) from the donor site.
- Recipient Site Preparation: The damaged skin area will be cleaned and prepared to receive the graft.
- Graft Placement: The harvested skin will be carefully placed on the damaged area. It may be secured with sutures, staples, or special dressings.
- Dressing: Both the donor and recipient sites will be covered with sterile dressings to protect against infection and to aid in healing.
Duration
The procedure typically takes about 1 to 2 hours, depending on the size and location of the graft.
Setting
The procedure is performed in a hospital or a specialized surgical center.
Personnel
- Surgeon specialized in dermatology or plastic surgery
- Anesthesiologist (if general anesthesia is used)
- Surgical nurses
- Operating room assistants
Risks and Complications
- Infection at donor or recipient sites
- Graft failure or rejection
- Scarring or pigment changes
- Pain and discomfort
- Bleeding or hematoma formation
- Rarely, complications from anesthesia
Benefits
- Accelerated healing of the damaged skin area
- Decreased risk of infection
- Improved appearance and function of the skin
- Potentially shorter hospital stay and recovery time
Recovery
- Regular dressing changes and monitoring of both donor and graft sites for signs of infection.
- Pain management typically involves prescribed pain relief medication.
- Avoiding strenuous activities until the graft has fully healed.
- Follow-up appointments to monitor progress and ensure proper healing.
- Full recovery often takes several weeks, with gradual improvement over time.
Alternatives
- Conservative wound care: Dressings and topical treatments
- Synthetic or biological skin substitutes
- Negative pressure wound therapy (NPWT)
- Hyperbaric oxygen therapy Conservatively managed care typically involves more prolonged healing and higher infection risk, whereas other advanced treatments may not offer the same aesthetic results as an autograft.
Patient Experience
Patients may experience discomfort during the healing process at both the donor and recipient sites. Pain can be managed with medications, and proper wound care is essential to ensure good healing. Emotional support and education about the process can greatly benefit the patient and family’s experience.