replacement vs. allograft
You're both right in my opinion. Acellular means "engineered" and allograft means from a cadaver (or live donor but since we're talking skin here let's assume it is a cadaver <g>).
Here are my research notes and analysis.
FROM CPT ASSISTANT:
1) Description of Procedure (15170)
Acellular dermal
replacement, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
After the induction of anesthesia, hemostasis of the graft site is obtained with epinephrine-soaked laparotomy pads and/or a topical hemostatic agent. The acellular dermal replacement is
removed from the rinsing solution and a total of 100 sq cm is applied to the trunk and secured to the excised wound with interrupted sutures or surgical staples.
A net dressing is applied and expanded over the graft site and secured with staples to prevent mechanical shear. The wound is covered with gauze dressings and secured with a bulky dressing to further prevent mechanical shear.
2) Description of Procedure (15330)
Acellular dermal
allograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children
After the induction of anesthesia, hemostasis of the graft site is obtained with epinephrine-soaked laparotomy pads and/or a topical hemostatic agent. Acellular dermal allograft is
removed from the transport package. A total of 100 sq cm is applied to the trunk and secured to the wound with absorbable sutures.
The dermal graft is covered with a local skin flap (separately coded). The wound is covered with gauze dressings and secured with a bulky dressing to prevent mechanical shear.
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Laureen's Analysis:
The 2nd one would be from a cadaver but rather than a straight graft it is “engineered” thus making it an “acellular dermal allograft”. The 1st one is all engineered and does not use cadaver skin to start with. It is all man made in other words.
An example of an acellular dermal
allograft product would be AlloDerm by LifeCELL
http://www.lifecell.com/alloderm-regenerative-tissue-matrix/. It is an “accellular dermal matrix” derived from donated human skin tissue. Donated skin is processed to remove the epidermis. It's “decellularized” in that various cells, which can cause rejection, are removed.
An example of an accellular dermal
replacement product would be Integra by Integra Life Sciences
http://integralife.com/Plastic-and-...neName=Soft Tissue Solutions&ProductLineID=78
Thanks Francine for suggesting this as a question for Thursday nights webinar. See you then!