Xpansion® Micro-Autografting Kit Surgical Technique
The Xpansion micro-autografting kit consist of single-use disposable instruments designed to be used for the harvesting, mechanical preparation, and application of skin autografts for the purpose of transplantation onto wounds. This product is provided sterile for single patient use.
The preferred time of grafting is 3-7 days after debridement. When wound bed preparation is adequate, the wound site is treated to remove debris, decrease bacteria and prepare the wound. If indicated, systemic antibiotics can be used between debridement and grafting.
Every chronic and acute wound with signs of infection should be cultured. A positive culture in combination with clinical signs of infection as well as all cultures showing beta hemolytic streptococci, MRSA, or VRE should be treated with systemic and/or local antibiotics and grafting delayed.
Wound Bed Preparation
All necrotic material should be debrided. Complete narrow excision of the wound edges and the base is preferred to create a clean, granulating bed prior to grafting. Bleeding can be stopped with cautery or silver nitrate sticks.
Following debridement, a wound cleaner such as Vashe® and a hydroconductive dressing (Drawtex®) should be used to prepare the wound for grafting.
Contraindications and Risks
As with any surgical procedure, care should be exercised in treating preexisting conditions that may affect the success of the surgical procedure. Every patient is different and patient results may vary. Specifically, a wound with necrotic tissue or infection should not be grafted until adequate wound bed preparation has been achieved. When removing the skin graft from the donor site, the donor site should be dressed before touching the recipient wound in order to avoid cross-contamination from the recipient wound to the donor site. In addition, a skin graft that is too thick will produce a deep donor site resulting in delayed healing of the donor site. The donor site should not be located over bony prominences, as this could result in a graft that is too thick and a donor site that is difficult to heal.