Dermal 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:
Dermal Autograft, Trunk, Arms, Legs (First 100 sq cm or less, or 1% of body area of infants and children)
Summary
A dermal autograft involves transplanting skin from one part of the patient’s body to another area that needs repair. This procedure is commonly used to treat significant skin damage on the trunk, arms, or legs, especially in infants and children.
Purpose
The primary purpose of a dermal autograft is to repair and restore the function and appearance of skin that has been severely damaged by burns, injuries, infections, or surgical removal. The main goal is to promote healing and improve the patient's quality of life.
Indications
- Severe burns or thermal injuries
- Extensive skin loss due to trauma or surgery
- Chronic, non-healing wounds
- Congenital skin defects
- Post-infection tissue loss
Preparation
- Patients may be instructed to fast for a certain period before the procedure if anesthesia is planned.
- Adjustments to medications might be necessary, such as stopping blood thinners.
- Pre-operative assessments, including blood tests and possibly imaging, may be performed.
Procedure Description
- Anesthesia: The patient will receive either local or general anesthesia, depending on the extent of the procedure and patient needs.
- Harvesting the Graft: Skin is harvested from a donor site (typically an area that can be easily concealed or less sensitive to scarring).
- Preparation of Recipient Site: The damaged area is cleaned and prepared to receive the graft.
- Transplantation: The harvested skin is carefully transplanted to the recipient site and secured with sutures, staples, or adhesive dressings.
- Dressing: A sterile dressing is applied to protect the graft and promote healing.
Duration
The procedure typically takes between 1 to 2 hours, depending on the size and location of the graft.
Setting
This procedure is performed in a hospital setting, either in an operating room or a specialized surgical center.
Personnel
- Surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technicians
Risks and Complications
- Infection at the donor or recipient site
- Graft failure or rejection
- Scarring at the donor or recipient site
- Pain or discomfort
- Bleeding or hematoma formation
- Anesthesia-related complications
Benefits
The main benefits include effective healing of the damaged area, reduced risk of infection, and improved functional and cosmetic outcomes. Healing typically starts within a few days, with noticeable improvements within weeks.
Recovery
- Post-procedure, the patient will be monitored, and pain management will be provided.
- Instructions for wound care at both the donor and recipient sites will be given.
- Activity restrictions and follow-up appointments will be scheduled.
- Recovery times vary but generally range from a few weeks to a couple of months.
Alternatives
- Skin substitutes (synthetic or biological)
- Allografts (skin from a donor, often cadaveric)
- Tissue expansion techniques
- Topical treatments and dressings
Each alternative has its own set of pros and cons, such as varying rates of acceptance by the body and differing healing times.
Patient Experience
During the procedure, the patient will be under anesthesia and should not feel pain. Postoperatively, discomfort or pain at the graft and donor sites is managed with prescribed pain medications. Patients may experience some tightness or soreness, and proper wound care measures are crucial for comfort and effective healing.