Name of the Procedure:

• Common Name(s): Dermagraft
• Technical/Medical Term: Dermagraft Treatment (per square centimeter) - HCPCS Code Q4106

Summary

Dermagraft is a medical procedure that involves applying a bio-engineered skin substitute to aid in the healing of skin wounds. This procedure is used to treat chronic, non-healing wounds, such as diabetic foot ulcers, by promoting the growth of healthy skin cells.

Purpose

• Conditions Addressed: Chronic wounds like diabetic foot ulcers, venous leg ulcers, and pressure ulcers.
• Goals/Outcomes: To accelerate wound healing, reduce the risk of infection, and improve the quality of life for patients with chronic wounds.

Indications

• Symptoms/Conditions: Non-healing ulcers, typically diabetic foot ulcers that have not responded to conventional treatment within a certain timeframe.
• Patient Criteria: Chronic wounds that demonstrate no significant healing after 4 weeks of standard wound care. Patients should not have active infection at the wound site.

Preparation

• Pre-Procedure Instructions: Patients may need to stop certain medications such as blood thinners and should follow advice on wound care leading up to the procedure.
• Diagnostic Tests: Assessment of the wound and surrounding skin, blood tests to ensure no infection or underlying conditions that might interfere with healing.

Procedure Description

• Step-by-Step Explanation:
  1. The wound area is cleaned and debrided (removal of dead tissue).
  2. Sterile Dermagraft material is prepared, cut to the size of the wound.
  3. Dermagraft is applied directly onto the wound bed.
  4. The application is covered with a non-adherent dressing to keep the material in place.
• Tools/Equipment: Sterile scissors, gloves, dressing materials.
• Anesthesia/Sedation: Typically, no anesthesia or sedation is required, though local anesthesia may be used if necessary for patient comfort.

Duration

• Procedure Length: The application procedure typically takes around 30 minutes to complete.

Setting

• Location: Outpatient clinic or wound care center.

Personnel

• Healthcare Professionals: Trained wound care specialist, nurse, possibly a physician for assessment and overall care plan.

Risks and Complications

• Common Risks: Localized redness or irritation.
• Rare Risks: Infection, allergic reaction to the Dermagraft material, failed integration of the graft.
• Management: Close monitoring of the wound for signs of infection or adverse reactions.

Benefits

• Expected Benefits: Quicker and more effective wound healing, reduction in wound size and depth, decreased risk of wound-related complications.
• Timeline: Benefits may be realized within weeks, with noticeable improvement in wound healing by 4-8 weeks.

Recovery

• Post-Procedure Care: Regular wound care follow-up appointments. Keeping the wound clean and protected as per the healthcare provider's instructions.
• Recovery Time: Varies depending on the size and severity of the wound, generally several weeks.
• Restrictions: Limiting pressure or friction on the treated area, avoiding activities that could interfere with healing.

Alternatives

• Other Treatment Options: Standard wound care (cleansing, debridement, traditional dressings), negative pressure wound therapy (wound vac), and other bioengineered skin substitutes.
• Pros/Cons of Alternatives: Alternatives might be less costly or more widely available but may take longer for wounds to heal or be less effective in certain patients.

Patient Experience

• During the Procedure: Patients might feel minor discomfort during the debridement process. The application of Dermagraft itself is typically painless.
• After the Procedure: Some mild discomfort or itching can occur as the wound heals. Pain management typically involves over-the-counter pain relievers, and the patient should follow the healthcare provider's guidelines for wound care maintenance.