CPT® Code 15336

Deleted

1. Indications

The acellular dermal allograft procedure is indicated for various conditions and situations where skin or soft tissue defects need to be addressed. These indications 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 often indicated in reconstructive surgeries aimed at restoring the appearance and function of affected areas.
• Burn Treatment Initially developed for burn patients, the graft is indicated for treating burn wounds that require skin coverage.
• Dental and Oral Procedures It is also indicated in dental and oral surgeries where soft tissue coverage is necessary.
• Plastic and Cosmetic Procedures The graft is used in various plastic and cosmetic procedures to enhance aesthetic outcomes.

2. Procedure

The procedure for applying an acellular dermal allograft involves several critical steps to ensure proper placement and integration with the surrounding tissue. These steps include:

• Preparation of the Graft The acellular dermal allograft is removed from its packaging and rehydrated in an isotonic sodium chloride solution. This step is essential to restore the graft's pliability and facilitate its application to the wound bed.
• Trimming the Graft Once rehydrated, the graft is trimmed to the appropriate dimensions based on the size and shape of the wound. This ensures that the graft will adequately cover the defect without excess material that could impede healing.
• 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 placed in a single layer or multiple layers to achieve the desired 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 allowing for eventual absorption and healing.
• Trimming Excess Material Any excess graft material at the periphery of the wound is trimmed to ensure a neat and effective fit, which is crucial for optimal healing.
• Covering 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.
• Applying Dressings 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 following the application of an acellular dermal allograft is crucial for ensuring proper healing and minimizing complications. Patients are typically advised to keep the dressing intact and dry for a specified period, as determined by the healthcare provider. Regular monitoring of the graft site is essential to check for signs of infection, such as increased redness, swelling, or discharge. Patients may also be instructed on how to manage pain and discomfort, which can include the use of prescribed analgesics. Follow-up appointments are necessary to assess the healing process and to determine if any additional interventions are required. It is important to avoid any activities that could stress the graft site during the initial healing phase to promote optimal integration of the graft with the surrounding tissue.