Name of the Procedure:

Graftjacket Application (Q4107)
Common name: Graftjacket
Technical term: Acellular Dermal Matrix Graft Application

Summary

The Graftjacket procedure involves the application of a biocompatible material used to repair or replace damaged skin or tissue. This graft, per square centimeter, aids the body in healing wounds by providing a framework for new tissue growth.

Purpose

Graftjacket is used to treat medical conditions where tissue regeneration is needed, such as severe wounds, diabetic ulcers, and soft tissue defects resulting from trauma or surgery. The goal is to promote quicker and more effective healing and to reduce the risk of infection.

Indications

• Chronic diabetic foot ulcers that don't heal with standard care
• Surgical wounds or sites with insufficient tissue for closure
• Pressure ulcers in patients with limited mobility
• Large or complex traumatic wounds

Preparation

• The patient may be instructed to fast if sedation or anesthesia is planned.
• Medications such as anticoagulants might need to be adjusted.
• Pre-operative assessment includes blood tests and imaging studies (e.g., X-rays, MRI) to evaluate the wound or defect area.

Procedure Description

1. Preparation: The wound or defect area is cleansed and debrided to remove necrotic tissue.
2. Sizing and Placement: The Graftjacket material is sized according to the wound dimensions, cut to fit, and placed over the affected area.
3. Securement: The graft is carefully secured in place using sutures, staples, or adhesive strips.
4. Dressing: A sterile dressing is applied to protect the graft and promote a conducive healing environment.
5. Anesthesia: Local anesthesia is often used, although regional or general anesthesia may be necessary for larger or more complex graft sites.

Duration

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

Setting

This procedure is usually performed in an outpatient surgical center, hospital, or specialized wound care clinic.

Personnel

• Surgeons: Often specialized in vascular surgery, plastic surgery, or wound care.
• Nurses: Assist with pre-operative preparation, intraoperative support, and post-operative care.
• Anesthesiologists: If general or regional anesthesia is required.

Risks and Complications

• Infection at the graft site
• Graft rejection or failure to integrate
• Bleeding or hematoma formation
• Extended pain or discomfort at the application site
• Allergic reactions to materials used

Benefits

• Enhanced wound healing
• Reduced infection risk
• Better functional and aesthetic outcomes
• Quicker recovery times compared to some alternative methods

Recovery

• Post-procedure, patients are instructed to keep the dressing dry and clean.
• Limited movement of the affected area to promote graft adherence.
• Follow-up appointments for monitoring graft integration and wound healing.
• Recovery time varies but generally ranges from a few weeks to a couple of months, depending on wound complexity.

Alternatives

• Standard wound care with dressings and debridement.
• Skin grafting using the patient’s own skin (autograft).
• Use of other bioengineered skin substitutes.
• Hyperbaric oxygen therapy to promote wound healing.

Pros and cons should be evaluated based on specific patient needs, wound characteristics, and overall health conditions.

Patient Experience

Patients may feel mild to moderate discomfort during the procedure, primarily at the site of the wound. Post-procedure, pain management typically involves over-the-counter pain medications, although stronger prescriptions may be needed in some cases. Comfort measures include elevation of the affected limb, protective dressings, and limited physical activity to facilitate recovery.