Skin Substitute Procedure: Integra Meshed Bilayer Wound Matrix (C9363)

Name of the Procedure:

Commonly known as "Skin Substitute" or "Integra Wound Matrix Application." Medically termed as "Integra Meshed Bilayer Wound Matrix, per square centimeter" (HCPCS Code: C9363).

Summary

Integra Meshed Bilayer Wound Matrix is a procedure where a specially designed skin substitute is applied to a wound to promote healing and tissue regeneration. This synthetic matrix acts as a scaffold, aiding in the recovery of severe, complex wounds.

Purpose

The procedure aims to treat non-healing wounds, burns, and areas with significant tissue loss. By using the Integra Wound Matrix, the goal is to provide a temporary cover, allowing the body to regenerate new tissue and eventually heal the wound.

Indications

• Chronic, non-healing wounds
• Burn wounds
• Traumatic wounds with significant skin loss
• Surgical wounds that have not healed properly
• Patients with compromised healing, such as diabetics

Preparation

• No specific fasting required.
• Patients should inform their healthcare provider about any medications they are taking, especially blood thinners.
• A comprehensive wound assessment by a healthcare professional.
• Cleaning and potential debridement of the wound area.

Procedure Description

1. Wound Preparation: The wound is cleaned, and any dead tissue is removed.
2. Application: The Integra Meshed Bilayer Wound Matrix is trimmed to fit the wound size and then placed onto the wound bed.
3. Fixation: The matrix is secured with sutures or staples, and a secondary dressing is applied to keep it in place.
4. Healing Phase: The matrix acts as a scaffold, promoting new skin growth and eventual wound closure.

Tools and Equipment:

• Scalpel or scissors for trimming the matrix
• Sutures or staples for fixation
• Secondary dressing materials

Anesthesia: Local anesthesia may be used to numb the application area to minimize discomfort.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the size and complexity of the wound.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Surgeon or wound care specialist
• Nurses to assist with the procedure and wound care
• Anesthesiologist or nurse for administering local anesthesia

Risks and Complications

• Infection at the wound site
• Matrix rejection or failure to integrate
• Allergic reactions to materials
• Possible need for additional procedures if healing does not progress as expected

Benefits

• Promotes faster and more effective wound healing
• Reduces frequency and severity of infections
• Provides immediate wound coverage, which is essential in burn management
• Patients may begin to see positive results within weeks, although complete healing may take longer.

Recovery

• Dressings need regular changes as directed by the healthcare provider.
• Keep the wound area dry and clean.
• Follow-up appointments are necessary to monitor healing progress.
• Avoid strenuous activities that may disturb the wound site until fully healed.

Alternatives

• Traditional wound care and dressings
• Other biologically derived skin substitutes
• Skin grafts from the patient or a donor (autografts or allografts)

Pros and Cons:

• Traditional dressings may be less expensive but may not be as effective in promoting complex wound healing.
• Skin grafts can provide immediate wound closure but involve additional surgical procedures.

Patient Experience

During the procedure, the patient may feel slight discomfort or pressure, but local anesthesia will minimize pain. Afterward, patients may experience mild soreness at the wound site, which can be managed with prescribed pain medication. Regular follow-up and proper wound care can enhance comfort and support healing.