CPT® Code 15175

Deleted

1. Indications

The acellular dermal replacement procedure is indicated for the treatment of skin defects in various anatomical regions. The specific indications include:

• Facial Defects Skin defects located on the face that require coverage and restoration.
• Scalp Defects Areas of the scalp that have experienced loss of skin integrity.
• Eyelid Defects Skin defects affecting the eyelids, which are critical for eye protection and function.
• Mouth Defects Skin defects in the oral region that may impact function and aesthetics.
• Neck Defects Skin defects on the neck that require reconstruction.
• Ear Defects Skin defects affecting the ears, which may require surgical intervention.
• Orbital Defects Skin defects around the eye socket that need coverage.
• Genitalia Defects Skin defects in the genital area that require specialized care.
• Hand and Foot Defects Skin defects on the hands and feet, including multiple digits, that necessitate reconstruction.

2. Procedure

The procedure for applying an acellular dermal replacement involves several critical steps to ensure effective coverage of the skin defect. The first step is to prepare the acellular dermal replacement sheets by removing them from their packaging and rinsing them in normal saline to ensure they are clean and ready for application. Following this, the sheets are meshed to enhance their integration with the surrounding tissue, which is crucial for promoting healing and minimizing complications. Once prepared, 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 they are firmly in place without overlapping, as this could compromise the healing process. Any excess material at the periphery of the wound is trimmed to fit the defect precisely, allowing for a clean and effective application. After the acellular dermal replacement is positioned, a layered dressing is applied to protect the area and facilitate healing. This dressing typically consists of an elastic net fixation layer, which is secured with staples, followed by an antimicrobial layer, such as silver nitrate, to prevent infection. A bulky layer of gauze is then added, along with a compression layer to support the wound, and finally, an anti-shear layer to protect the site from friction and movement.

3. Post-Procedure

Post-procedure care for patients who have undergone acellular dermal replacement is crucial for ensuring optimal healing and minimizing complications. After the application of the acellular dermal replacement and the layered dressing, patients are typically monitored for any signs of infection or complications. It is important to keep the area clean and dry, and patients may be advised to avoid strenuous activities that could disrupt the dressing or the healing process. Follow-up appointments are essential to assess the healing progress and to make any necessary adjustments to the dressing. The layered dressing should remain intact for a specified period, as determined by the healthcare provider, to protect the wound and support the healing process. Patients may also receive instructions on how to care for the site at home, including signs of infection to watch for and when to seek further medical attention. Overall, proper post-procedure care is vital for achieving the best possible outcomes following the acellular dermal replacement procedure.