CPT® Code 15171

Deleted

1. Indications

The acellular dermal replacement procedure is indicated for the treatment of skin defects located on the trunk, arms, or legs. This procedure is particularly beneficial in the following scenarios:

• Skin Defects The procedure is performed to cover significant skin defects resulting from trauma, surgical excisions, or congenital anomalies.
• Burns It is indicated for patients with burn injuries that require skin replacement to promote healing and restore skin integrity.
• Chronic Wounds The procedure is suitable for chronic wounds that have not responded to conventional treatments, necessitating a more advanced approach to wound management.

2. Procedure

The acellular dermal replacement procedure involves several critical steps to ensure effective application and healing. The following outlines the procedural steps:

• Preparation of the Wound Bed The first step involves preparing the wound bed to ensure it is clean and free of debris. This may include debridement of necrotic tissue and thorough cleansing with saline to create an optimal environment for the acellular dermal replacement.
• Preparation of Acellular Dermal Replacement Sheets The acellular dermal replacement sheets are then removed from their packaging. They are rinsed in normal saline to ensure sterility and to prepare them for application. This step is crucial to eliminate any preservatives or contaminants that may be present.
• Meshing the Sheets After rinsing, the sheets are meshed to enhance their flexibility and adaptability to the contours of the wound. Meshing allows for better integration with the surrounding tissue and facilitates drainage.
• Application of the Sheets The meshed sheets are carefully applied over the prepared wound bed. It is essential to secure the sheets using interrupted sutures or staples, ensuring that there is no overlap between the sheets to maintain proper coverage and healing.
• Trimming Excess Material Any excess material at the periphery of the wound is trimmed to ensure a precise fit. This step helps to prevent complications such as irritation or infection at the edges of the wound.
• Layered Dressing Application Following the application of the acellular dermal replacement, a layered dressing is applied. This includes an elastic net fixation layer, which is secured with staples, followed by an antimicrobial layer, such as silver nitrate, to prevent infection. Additional layers of bulky gauze, compression, and anti-shear materials are then added to protect the site and promote healing.

3. Post-Procedure

Post-procedure care is essential to ensure optimal healing and minimize complications. After the application of the acellular dermal replacement, the patient should be monitored for any signs of infection or adverse reactions. The layered dressing should remain intact and be changed according to the healthcare provider's instructions. Patients may be advised to avoid excessive movement or pressure on the treated area to facilitate healing. Follow-up appointments are necessary to assess the healing process and to determine if any additional interventions are required. Proper education on wound care and signs of complications should be provided to the patient and caregivers to ensure a successful recovery.