APPLICATION DIRECTIONS
1. Wound at Presentation
2. Debride the Wound. GammaGraft will not adhere to an
infected site or an area with a lot of necrotic tissue.
3. Apply GammaGraft. Fixate GammaGraft with sutures or other means.
4. Cover with Non-Adherent Dressing
5. Cover with dry gauze
6. Remove cover dressings and air-dry. Physicians may choose to allow
the GammaGraft to air dry the next day or later in treatment.
GammaGraft™ Application Directions
1. Clean the wound bed
Using sterile technique, the wound should be thoroughly cleaned. Devitalized tissue, including blister epithelium, should be debrided.
2. Apply the GammaGraft™
The GammaGraft™ is folded over on itself, dermis side to dermis side, inside the package's gauze pad. Remove the GammaGraft™ from the package holding it with forceps at its edges. Apply the dermis side of the GammaGraft to the wound. The dermis is shiny, in contrast to the epidermis, and the graft edges will curl toward the dermis side.
Apply as a single layer and smooth out the graft to allow the best adherence. The wound site should not be actively bleeding at the time of GammaGraft™ application. To protect the GammaGraft™, a dressing of Adaptic or similar non-adherent gauze and overlying dry gauze secured with tape or elastic net should be used. The dressing should be chosen to minimize the chance of the GammaGraft™ being sheared off by contact pressure during movement. The GammaGraft™ may be held in place with surgical staples on larger wounds. The outermost keratin layer (the cornified layer) may be slightly pasty from hydration. This is the result of being stored moist for an extended period. For best results, do not scrape off this layer when applying the GammaGraft™ to the wound. This layer will dry and form part of the protective barrier of the GammaGraft™. Areas that do not face shear forces may simply be dressed with GammaGraft™ and left open to air-dry without a dressing.
3. Wait 24 hours and Remove Cover Dressings
After 24 hours with GammaGraft™ in place, the secondary wound coverings should be removed and the wound should be left to air-dry for 2-3 hours. Patients typically remove the cover dressings on their own at home. If the GammaGraft™ has not adhered well (if it is able to be moved easily with a gloved finger) then the wound site should be evaluated for possible surface infection. In the event that purulence accumulates under the GammaGraft™ it should be removed and the wound treated appropriately to lower its bacterial count. GammaGraft™may be reapplied when wound biology is favorable. After the GammaGraft™ has dried, the patient should not need any other dressing changes and they may bathe and shower with GammaGraft™in place.
4. Patient Home Care
Excessive shearing and rubbing of the GammaGraft™ should be avoided. Patients may bathe and shower with GammaGraft™ in place. The GammaGraft™ should be patted dry after becoming wet. As the edges of the covered wound begin to heal from the sides, the GammaGraft™ will begin to curl up and be lifted at the wound edges. Unattached edges may be trimmed back by health care professionals or to eliminate any possible discomfort, pieces of paper tape may be applied to these edges to eliminate snagging on clothing. The GammaGraft™ will slough off on its own as the wound reepithelializes. Due to varying degrees of wound depth and rates of healing, some areas of GammaGraft™ may remain on the wound longer than other areas. Areas where GammaGraft™ has remained are not completely healed. On some partial thickness wounds - especially those of nutritionally depleted and immunosuppressed patients - GammaGraft™ will remain for 4 to 6 weeks while healing occurs. On full thickness wounds, GammaGraft™ will usually persist from 2 to 6 weeks depending on local wound conditions. GammaGraft™ can serve as an excellent self-adhering wound cover until definitive coverage is obtained through skin grafting or healing by secondary intension.