Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less
CPT4 code
Name of the Procedure:
Tissue Cultured Skin Autograft; Face, Scalp, Eyelids, Mouth, Neck, Ears, Orbits, Genitalia, Hands, Feet, and/or Multiple Digits; First 25 sq cm or Less
Summary
A tissue cultured skin autograft is a procedure where skin cells are harvested from the patient, cultured in a lab to grow new skin, and then grafted onto areas of the body needing repair or regeneration. This technique is often used for facial, scalp, eyelid, mouth, neck, ear, orbital, genital, hand, foot, and multiple digit reconstruction. The procedure is typically performed on areas up to 25 square centimeters or less.
Purpose
This procedure addresses severe skin damage or loss due to burns, injuries, surgeries, or medical conditions. The goal is to promote healing, restore function, and improve the cosmetic appearance of the affected areas.
Indications
- Severe burns or thermal injuries
- Extensive skin loss due to trauma or surgery
- Chronic wounds or ulcers
- Cosmetic reconstruction in cases of skin defects
- Patients who meet specific medical criteria for skin grafting therapy
Preparation
- Pre-procedure instructions may include fasting for a certain period.
- Adjustments or discontinuation of specific medications, particularly blood thinners.
- Diagnostic tests such as blood work and imaging to evaluate the affected area.
Procedure Description
- Harvesting Skin Cells: Small skin samples are taken from an area of the body, usually hidden or less noticeable.
- Culturing: The cells are cultured in a laboratory to grow new skin tissue over a period of weeks.
- Grafting: Once the cultured skin is ready, it is transplanted to the affected area.
- Fixation: The graft is secured using surgical techniques to ensure proper attachment and healing.
- Tools and Equipment: Surgical instruments, sterile lab equipment for cell culture, fixation devices.
- Anesthesia: Generally performed under local or general anesthesia depending on the size and location of the graft.
Duration
The in-lab skin culturing process can take several weeks, but the actual grafting procedure typically takes about 1 to 2 hours.
Setting
The grafting part of the procedure is performed in a hospital or surgical center.
Personnel
- Surgeons specialized in plastic or reconstructive surgery
- Nurses and surgical assistants
- Anesthesiologists, if general anesthesia is used
Risks and Complications
- Common: Infection, graft rejection, scarring, and pain at donor site.
- Rare: Severe allergic reactions, poor graft attachment, or extensive bleeding.
Benefits
- Promotes wound healing and tissue regeneration
- Restores function and appearance of damaged areas
- Potentially quicker healing compared to other methods
- Improved cosmetic results and quality of life
Recovery
- Post-procedure care includes wound care, possible use of dressings, and instructions on how to care for the graft area.
- Recovery time varies but generally spans several weeks to months. Activity restrictions may be advised.
- Follow-up appointments are necessary to monitor graft healing and address any complications.
Alternatives
- Other Treatments: Traditional skin grafting, synthetic skin substitutes, wound healing therapies.
- Pros and Cons: Traditional grafting might have a quicker preparation time but less favorable cosmetic outcomes; synthetic skins can be immediate but may not integrate as well as autografts.
Patient Experience
- During the procedure: Patients will be under anesthesia and should feel no pain during the grafting process.
- After the procedure: Pain and discomfort are common but manageable with pain medications. The patient may experience swelling, redness, and temporary limited function in the grafted area.
- Follow-up care is crucial for optimal results, involving frequent dressing changes and possibly physical therapy.