Name of the Procedure:

• Common Name(s): Memoderm, Dermaspan, Tranzgraft, Integuply
• Technical/Medical Term: Application of bioengineered skin substitutes, per square centimeter (HCPCS Code: Q4126).

Summary

This procedure involves the application of bioengineered skin substitutes to areas of damaged or missing skin. These products (Memoderm, Dermaspan, Tranzgraft, Integuply) are designed to mimic natural skin layers and facilitate healing.

Purpose

The primary goal of this procedure is to treat severe skin wounds or conditions such as burns, ulcers, and other skin injuries. The application of skin substitutes can promote faster and more effective healing, reduce the risk of infection, and improve overall skin function and appearance.

Indications

• Chronic non-healing wounds (e.g., diabetic ulcers, venous ulcers)
• Severe burns
• Traumatic skin injuries
• Surgical wounds that are not healing properly
• Patients who cannot use autografts

Preparation

• The area to be treated should be clean and free from infection.
• Patients may need to stop certain medications (e.g., blood thinners) as advised by their doctor.
• Pre-procedure consultations and assessments, including blood tests or imaging studies, may be required.

Procedure Description

1. The patient is positioned to expose the treatment area.
2. Anesthesia or sedation may be administered depending on the wound severity and patient comfort.
3. The wound is meticulously cleaned and debrided to remove dead tissue.
4. The bioengineered skin substitute is carefully measured, cut to size, and applied to the wound surface.
5. The graft is secured with sutures, staples, or adhesive strips.
6. A sterile dressing is applied to protect the graft and promote healing.

Duration

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

Setting

It is performed in various settings, including hospitals, outpatient clinics, and surgical centers.

Personnel

• A surgeon or wound care specialist
• Nurses
• An anesthesiologist (if anesthesia is required)

Risks and Complications

• Infection
• Graft rejection or failure
• Adverse reactions to anesthesia
• Scarring
• Bleeding

Benefits

• Accelerated wound healing
• Reduced risk of infection
• Improved cosmetic and functional outcomes
• Potential reduction in pain

Recovery

• Patients will receive instructions on wound care, including how to change dressings.
• Activity may be limited to avoid disrupting the graft.
• Follow-up appointments will be scheduled to monitor healing and progress.
• Full recovery can take weeks to months depending on the size of the wound and the patient's overall health.

Alternatives

• Traditional autografting (using the patient’s own skin)
• Allografts (skin from a donor)
• Synthetic dressings
• Hyperbaric oxygen therapy
• Pros and cons: Alternatives may involve longer healing times, more extensive surgery, or different risk profiles.

Patient Experience

• Some discomfort or pain during and after the procedure, which can be managed with medication.
• Clear instructions on wound care to ensure proper healing.
• Regular follow-up visits for monitoring and potential adjustments to the treatment plan.