Diabetic Ulcer with Xenograft
Good Morning,
I have a case where patient is Diabetic with right midfoot diabetic ulcer with osteomyelitis. Pt was taken to OR for debridement with application of xenograft and application of Wound VAC. The op report states "the ulcer was debrided excisionally through the muscle tissue down to healthy-appearing bone. Then, using a curette and VersaJet Hydrosurgery instrumentation, the remaining nonviable tissue was removed." The graft was placed and collagen from the excessive portion of the graft was packed into the sinus tract.
So, I've said all of that to ask this...OASIS Guidance tells us that Pressure Ulcers that undergo grafting ARE NOT considered surgical wounds, but I don't find anything that talks about Diabetic Ulcers that are grafted. Would this wound now be considered Surgical? There is no donor site to consider for surgical wound because Xenograft was used.
Thanks!
I have a case where patient is Diabetic with right midfoot diabetic ulcer with osteomyelitis. Pt was taken to OR for debridement with application of xenograft and application of Wound VAC. The op report states "the ulcer was debrided excisionally through the muscle tissue down to healthy-appearing bone. Then, using a curette and VersaJet Hydrosurgery instrumentation, the remaining nonviable tissue was removed." The graft was placed and collagen from the excessive portion of the graft was packed into the sinus tract.
So, I've said all of that to ask this...OASIS Guidance tells us that Pressure Ulcers that undergo grafting ARE NOT considered surgical wounds, but I don't find anything that talks about Diabetic Ulcers that are grafted. Would this wound now be considered Surgical? There is no donor site to consider for surgical wound because Xenograft was used.
Thanks!
Comments
This one is tricky.
Skin grafting is a treatment of an existing wound, not a surgical procedure. In addition, a debridement is also a treatment to a wound and not a surgical procedure. So these two do not make it a surgical wound.
Although, a surgical procedure that involves EXCISION of necrotic tissue beyond general debridement (such as excision of a necrotic mass), excision of mesh or other appliances or structures goes beyond a simple I&D and the resulting lesion would be reported as a surgical wound.
This information is OASIS guidelines out of the OASIS Answers "purple" book.