Name of the Procedure:

Puraply and Puraply Antimicrobial Application
Common names: Puraply, Puraply AM
Medical term: HCPCS Code: C9349

Summary

Puraply and Puraply Antimicrobial are medical treatments used to manage and treat complex wounds. These treatments involve applying a biologically active collagen matrix to the wound site, which helps support the healing process. The procedure is typically measured per square centimeter of application area.

Purpose

The purpose of applying Puraply or Puraply Antimicrobial is to promote faster and more efficient wound healing. They are especially effective in treating chronic and acute wounds by assisting in the formation of new tissue and reducing infections.

Indications

This procedure is indicated for patients with:

• Chronic wounds (e.g., diabetic foot ulcers, venous leg ulcers)
• Acute wounds (e.g., surgical wounds, traumatic wounds)
• Wounds at risk of infection or those that show signs of infection

Criteria that make the procedure appropriate include:

• Non-healing wounds despite conventional treatment
• Wounds with significant depth or complexity
• Patients in need of a biocompatible material to support tissue regeneration

Preparation

• Patients may need to fast for a few hours before the procedure, especially if anesthesia is to be used.
• Any medications or allergies should be discussed with the healthcare provider.
• A pre-procedure assessment, including diagnostic imaging or cultures, might be required to evaluate the wound.

Procedure Description

1. The wound area is first cleaned and debrided to remove any dead tissue.
2. The healthcare provider then measures the wound to determine the amount of Puraply or Puraply Antimicrobial needed.
3. The collagen matrix material is cut to fit the size and shape of the wound.
4. The Puraply or Puraply Antimicrobial is then carefully placed onto the wound bed.
5. A secondary dressing may be applied to secure the Puraply material in place.
6. The wound is monitored over subsequent visits to ensure proper integration and healing.

Tools and Equipment:

• Sterile gloves and instruments
• Scalpel or scissors for debridement and cutting the matrix
• Dressings to cover and secure the application

Anesthesia and Sedation:

• Local anesthesia is often used for pain management, though general anesthesia may be required for larger, more complex wounds.

Duration

The procedure typically takes about 30-60 minutes depending on the size and complexity of the wound.

Setting

This procedure is primarily performed in a hospital, outpatient clinic, or a specialized wound care center.

Personnel

• Wound care specialists or surgeons
• Nurses
• Anesthesiologists (if anesthesia is required)

Risks and Complications

Common Risks:

• Minor bleeding
• Pain or discomfort at the application site

Rare Risks:

• Infection
• Allergic reaction to the material

Complications are usually manageable with appropriate medical intervention.

Benefits

• Faster wound healing
• Reduced infection rates with Puraply Antimicrobial
• Improved tissue regeneration
• Reduced need for additional surgical interventions

Benefits might be realized within a few days to weeks, depending on the wound's severity and patient response.

Recovery

Post-procedure care:

• Keep the wound area clean and dry.
• Follow dressing change instructions provided by the healthcare provider.
• Regular follow-up appointments to monitor wound healing.

Expected recovery time varies, but patients may see significant improvement within a few weeks.

Alternatives

Alternative treatment options include:

• Standard wound dressings
• Hyperbaric oxygen therapy
• Negative pressure wound therapy
• Skin grafts

Each alternative has its own set of pros and cons in terms of effectiveness, cost, and patient suitability.

Patient Experience

During the procedure, patients might feel minor discomfort, particularly during the debridement phase. Post-procedure, some initial pain and redness are common, but pain management strategies, including local pain relief medications, can significantly improve comfort. The overall experience is generally positive, with most patients noticing steady wound improvement over the recovery period.