CPT® Code 15331

Deleted

1. Indications

The acellular dermal allograft procedure is indicated for the treatment of skin defects located on the trunk, arms, or legs. This procedure is particularly relevant for patients requiring coverage of significant skin loss due to various conditions, including but not limited to:

• Burns: Severe burns that result in extensive skin damage necessitating grafting for proper healing.
• Trauma: Skin defects resulting from traumatic injuries that compromise the integrity of the skin.
• Reconstructive Surgery: Surgical procedures aimed at restoring the appearance and function of damaged skin.
• Cosmetic Procedures: Enhancements or corrections in the skin that require grafting for aesthetic purposes.

2. Procedure

The procedure for applying an acellular dermal allograft involves several critical steps to ensure effective coverage of the skin defect. Each step is essential for the successful integration of the graft into the patient's tissue.

• Preparation of the Graft: The acellular dermal allograft sheets are removed from their packaging and rehydrated in an isotonic sodium chloride solution. This rehydration process is crucial as it restores the graft's pliability and prepares it for application.
• Trimming the Graft: Once rehydrated, the graft sheets are trimmed to the appropriate dimensions that correspond to the size and shape of the wound bed. This step ensures that the graft will fit properly over the defect without excess material that could impede healing.
• Application of the Graft: The trimmed graft sheets are then applied over the prepared wound bed. Depending on the size of the defect, the graft may be applied in a single layer or multiple layers to provide adequate coverage and support for healing.
• Securing the Graft: The graft is secured in place using absorbable sutures, which eliminate the need for suture removal later and minimize discomfort for the patient.
• Trimming Excess Material: Any excess graft material at the periphery of the wound is carefully trimmed to ensure a neat and effective fit, which is vital for optimal healing.
• Layering with Skin Flap: If necessary, the acellular dermal allograft layers may be covered with a separately reportable skin flap to enhance the healing process and provide additional support.
• Applying Dressings: Finally, a layered dressing is applied over the graft site. This dressing typically includes a bulky layer of gauze to absorb any exudate, a compression layer to support the graft, and an anti-shear layer to protect the graft from friction and movement.

3. Post-Procedure

Post-procedure care for patients receiving an acellular dermal allograft is critical to ensure proper healing and minimize complications. Patients are typically monitored for signs of infection or graft rejection. It is essential to keep the dressing intact and dry for a specified period, as directed by the healthcare provider. Follow-up appointments are necessary to assess the healing process and to determine if any additional interventions are required. Patients may also receive instructions on how to care for the graft site at home, including guidelines on activity restrictions and signs of complications to watch for. Overall, the success of the acellular dermal allograft procedure relies heavily on adherence to post-procedure care protocols and regular follow-up evaluations.