15273 Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

Name of the Procedure:

Application of Skin Substitute Graft to Trunk, Arms, Legs

Summary

The application of a skin substitute graft involves placing a specially designed artificial or biological skin substitute over a large wound area on the trunk, arms, or legs. The graft covers and protects the wound, promoting healing.

Purpose

The purpose of this procedure is to treat extensive skin wounds that cannot heal properly on their own. It helps in covering large areas of damaged skin, preventing infection, and promoting new skin growth.

Indications

• Severe burns
• Extensive cuts or abrasions
• Non-healing ulcers
• Chronic wounds
• Large areas of skin damage due to trauma or surgery

Preparation

• Follow fasting instructions if general anesthesia is to be used.
• Adjust medications as instructed by the healthcare provider.
• Undergo any necessary blood tests or imaging studies.

Procedure Description

1. The patient is prepared and positioned appropriately.
2. Anesthesia is administered (local or general, depending on the case).
3. The wound is cleaned and debrided (removal of dead tissue).
4. The skin substitute graft is carefully placed over the wound area.
5. The graft is secured using sutures, staples, or adhesive strips.
6. A sterile dressing is applied over the graft.

Tools and Equipment:

• Skin substitute material (synthetic or biological)
• Surgical tools for debridement and grafting
• Sterile dressings

Duration

The procedure typically takes 1 to 2 hours, depending on the size of the wound.

Setting

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

Personnel

• Surgeon
• Surgical nurse
• Anesthesiologist (if general anesthesia is required)
• Support staff for assistance

Risks and Complications

• Infection at the graft site
• Rejection of the skin substitute
• Delayed wound healing
• Scarring
• Bleeding
• Pain or discomfort at the graft site

Benefits

• Promotes faster and more effective wound healing
• Reduces the risk of infection
• Minimizes scarring
• Improves the appearance and function of the affected area

Recovery

• Follow post-procedure care instructions, such as keeping the area clean and dry.
• Attend follow-up appointments for wound assessment and dressing changes.
• Recovery time varies but typically ranges from several weeks to a few months.
• Activity restrictions may be advised to protect the graft site.

Alternatives

• Traditional skin grafting
• Negative pressure wound therapy (vacuum-assisted closure)
• Advanced wound dressings
• Hyperbaric oxygen therapy

Pros and Cons of Alternatives:

• Traditional grafting uses the patient's own skin but requires a donor site.
• Negative pressure therapy may be less invasive but may take longer to heal.
• Advanced dressings need frequent changes and may be less effective for large wounds.
• Hyperbaric oxygen therapy aids in healing but requires specialized equipment and facilities.

Patient Experience

During the procedure:

• If under local anesthesia, some pressure or discomfort might be felt.
• If under general anesthesia, the patient will be unaware and pain-free.

After the procedure:

• Mild to moderate pain or discomfort at the graft site, manageable with prescribed pain relief.
• Swelling and bruising, which should subside over time.
• Regular follow-up visits to monitor healing and manage any complications.