CPT® Code 15335

Deleted

1. Indications

The acellular dermal allograft procedure is indicated for various conditions and situations where skin or soft tissue defects are present. These include:

• Skin Defects The procedure is performed to cover skin defects resulting from trauma, surgical excisions, or congenital anomalies.
• Soft Tissue Defects It is utilized to fill soft tissue defects that may arise from injury, disease, or surgical interventions.
• Reconstructive Surgery The graft is indicated in reconstructive procedures aimed at restoring the form and function of affected areas, particularly in the face, scalp, and other critical regions.
• Burn Treatment Initially developed for burn patients, this procedure is still relevant for treating burn injuries where skin grafting is necessary.
• Dental and Oral Procedures It is also indicated in dental and oral surgeries where soft tissue coverage is required.
• Plastic and Cosmetic Procedures The graft is used in various plastic and cosmetic surgeries to enhance aesthetic outcomes.

2. Procedure

The acellular dermal allograft procedure involves several critical steps to ensure successful application and integration of the graft. These steps include:

• Preparation of the Graft The acellular dermal allograft sheets are first removed from their packaging and rehydrated in an isotonic sodium chloride solution. This step is essential to restore the graft's pliability and facilitate its application.
• Trimming the Graft Once rehydrated, the graft sheets are trimmed to the appropriate dimensions based on the size and shape of the wound bed. This ensures a proper fit and coverage of the defect.
• Application of the Graft The trimmed graft is 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 achieve optimal coverage and support.
• Securing the Graft The graft is secured in place using absorbable sutures, which help to hold the graft firmly against the wound bed while it integrates with the surrounding tissue.
• Trimming Excess Graft Any excess graft material at the periphery of the wound is trimmed to ensure a neat and clean appearance, which is important for both healing and aesthetic outcomes.
• Layering with Skin Flap (if applicable) If the acellular dermal allograft is being used to fill a soft tissue defect, it may be covered with a separately reportable skin flap to provide additional support and protection.
• Post-Application Dressing After the graft is secured, a layered dressing is applied. This dressing typically includes a bulky layer of gauze to absorb any exudate, a compression layer to minimize swelling, 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 crucial for ensuring proper healing and minimizing complications. Patients are typically monitored for signs of infection or graft rejection. The layered dressing applied during the procedure should remain intact for a specified period, as directed by the healthcare provider. Patients may be advised to avoid strenuous activities that could disrupt the graft site during the initial healing phase. Follow-up appointments are essential to assess the integration of the graft and to make any necessary adjustments to the dressing or care plan. Additionally, patients should be educated on signs of complications, such as increased redness, swelling, or discharge from the graft site, and instructed to report these to their healthcare provider promptly.