Uses for Stratagraft
STRATAGRAFT is an allogeneic cellularized scaffold product indicated for the treatment of adults with thermal burns containing intact dermal elements for which surgical intervention is clinically indicated (deep partial-thickness burns).
Dosage for Stratagraft
Dosage
STRATAGRAFT is for topical application to a prepared wound bed (excision/debridement).
A STRATAGRAFT construct is an approximately 100 cm2 (approximately 8 cm by 12.5 cm) off-white rectangle. A STRATAGRAFT construct may be trimmed to fit the shape and size of the wound area. The surface area of STRATAGRAFT to be applied should be equal to the surface area of the wound to be treated.
Multiple constructs may be applied to cover large wound areas. If multiple constructs are required to cover the wound area, abut the STRATAGRAFT constructs, and it is not necessary to overlap the edges.
Each construct is for application to a single patient only.
Preparation
STRATAGRAFT is to be prepared in an appropriate surgical environment.
STRATAGRAFT Is Supplied As Follows
The STRATAGRAFT carton contains a laminated foil pouch (Figure 1).
Figure 1: STRATAGRAFT carton and foil pouch
Within the pouch is the STRATAGRAFT Product Dish that contains STRATAGRAFT on a polystyrene insert tray (Figure 2).
Figure 2: STRATAGRAFT Product Dish containing the STRATAGRAFT construct
Inside the STRATAGRAFT Product Dish is the polystyrene insert tray that contains the STRATAGRAFT construct (Figure 3).
STRATAGRAFT is loosely adhered to a polycarbonate membrane contained within a polystyrene insert tray frame.
Figure 3: STRATAGRAFT Product Dish and Insert Tray containing STRATAGRAFT
Hold Solution is provided in a plastic bottle contained within a laminated, foil pouch [see DESCRIPTION] (Figure 4).
Figure 4: Hold Solution within a laminated foil pouch
The Hold Dish is contained in a clear pouch (Figure 5) and consists of identical top and bottom portions (Figure 6).
Figure 5: Hold Dish contained within a clear pouch
Figure 6: Hold Dish handled in sterile field
Supplies
The following supplies are not included but are needed for the preparation:
- Mesher: STRATAGRAFT is compatible with autograft meshing devices (crushing or noncrushing) and can be meshed at ratios up to 1:1
- Warming oven/cabinet or water bath
Preparation Instructions
Following wound bed preparation (excision/debridement), determine the number of STRATAGRAFT constructs that need to be thawed.
The following instructions are for preparing one STRATAGRAFT construct. Two operators (one sterile operator and one non-sterile operator) are required.
If two or more STRATAGRAFT constructs are required, prepare them in one or more batches. STRATAGRAFT construct preparation should take approximately 20 minutes for a single construct or group of constructs.
Option 1:
Place Hold Solution bottle in a warming oven/cabinet operating at 35°C to 39°C (95°F to 102°F) for AT LEAST 45 minutes prior to use.
Option 2:
Place Hold Solution bottle in a water bath at 35oC to 39oC (95°F to 102°F) for AT LEAST 15 minutes prior to use. Do not submerge the cap or threads of the bottle.
Figure 7: Sterile operator (gray gloves) removes the sterile Hold Dish presented by the nonsterile operator (white gloves)
Figure 8: Sterile operator places the Hold Dish in the sterile field (gray rectangle)
Note: Steps 4-11 must be completed within 10 minutes of removal of STRATAGRAFT from the freezer or dry ice.
Figure 9: Remove foil pouch
Figure 10: Remove closed STRATAGRAFT Product Dish from foil pouch
Figure 11: Placement of STRATAGRAFT Product Dish in a nonsterile area
Figure 12: Nonsterile operator aseptically pours Hold Solution into the Hold Dish
Figure 13: Nonsterile operator (white gloves) opens the STRATAGRAFT Product Dish
Figure 14: Sterile operator (gray gloves) removes the STRATAGRAFT insert tray
If bubbles become trapped beneath the insert tray, gently lift the insert tray and place it slowly back down into the Hold Solution.
Figure 15: Sterile operator places Insert Tray into the Hold Dish
Do not allow STRATAGRAFT to dry. Moisten the mesher/tissue board as needed to prevent adhesion and maintain STRATAGRAFT moisture using Hold Solution, sterile 0.9% normal saline, or lactated Ringer's solution.
STRATAGRAFT is packaged with the dermal (shiny) side in contact with the polycarbonate membrane. The construct may be meshed (Figure 16) with either side up; note which side is the dermis (shiny) and which side is the epidermis (matte) prior to meshing and placement.
- Remove the Hold Solution bottle from the laminated, foil pouch. The Hold Solution is a clear liquid. Do not use the Hold Solution if the contents of the bottle appear cloudy or turbid. Use one bottle of Hold Solution for one construct being prepared for placement.
- Warm the Hold Solution in a warming oven/cabinet or a water bath.
- The nonsterile operator peels open the seal of the Hold Dish pouch and aseptically presents the Hold Dish to the sterile operator for placement in the sterile field (Figure 7). The sterile operator aseptically removes the Hold Dish presented by the nonsterile operator (Figure 7) and places it in the sterile field (Figure 8).
- Remove STRATAGRAFT carton from the freezer or dry ice.
- Open the STRATAGRAFT carton and remove the foil pouch (Figure 9).
- Peel the foil pouch open and carefully remove the closed STRATAGRAFT Product Dish (Figure 10).
- The unopened STRATAGRAFT Product Dish containing the construct may be placed on a flat surface outside of the sterile field (Figure 11).
- The nonsterile operator pours one entire bottle of warmed Hold Solution into one sterile Hold Dish using aseptic technique per institutional procedures, immediately after removing the warmed Hold Solution from the warming device (Figure 12).
- The nonsterile operator removes the STRATAGRAFT Product Dish lid and holds the STRATAGRAFT Product Dish without contacting the insert tray (Figure 13).
- The sterile operator aseptically removes the STRATAGRAFT insert tray from the STRATAGRAFT Product Dish using either sterile forceps or sterile, gloved fingers (Figure 14).
- The sterile operator uses sterile, gloved fingers to place the insert tray into the Hold Dish beginning with one edge and lowering it to the opposite edge to minimize trapping bubbles beneath the insert tray (Figure 15).
- Maintain the STRATAGRAFT construct in the Hold Solution for a minimum of 15 minutes to a maximum of 4 hours.
- Remove STRATAGRAFT from the polycarbonate membrane of the insert tray with sterile, gloved fingers or a pair of atraumatic forceps and mesh the STRATAGRAFT up to a 1:1 ratio.
Figure 16: Meshing STRATAGRAFT
Administration
STRATAGRAFT is applied in appropriate aseptic conditions by a trained healthcare provider.
Follow the steps below for topical application of STRATAGRAFT:
- If utilizing fibrin glue to anchor STRATAGRAFT, apply prior to placing the meshed STRATAGRAFT on the prepared wound bed. If utilizing anchoring methods other than fibrin glue, start with step 2.
- Place the meshed STRATAGRAFT with the dermal (shiny) side down in contact with the patient's prepared wound bed. Ensure the epidermal (matte) side is facing up. Abut the constructs when placing multiple STRATAGRAFT constructs. Overlapping the STRATAGRAFT construct edges is not required.
Note: If the area to be treated is smaller than one construct, trim excess STRATAGRAFT before or after anchoring to the wound bed. Ensure that STRATAGRAFT has contact across the entire surface of the wound bed. Do not stretch or expand STRATAGRAFT, as doing so may degrade the structural integrity of STRATAGRAFT.
- Anchor STRATAGRAFT with staples, tissue adhesive such as cyanoacrylate, or sutures to keep STRATAGRAFT from dislodging. Place a porous, nonadherent contact dressing over STRATAGRAFT and leave the dressing in place for one week before changing.
- Place a second layer of dressing that does not contain silver [see DRUG INTERACTIONS].
- Placement of an outer bolster or wrap that keeps STRATAGRAFT from moving as clinically appropriate is at the discretion of the physician.
HOW SUPPLIED
Dosage Forms And Strengths
STRATAGRAFT is an off-white, rectangular sheet of approximately 100 cm2 (approximately 8 cm by 12.5 cm) consisting of a viable, bioengineered, allogeneic cellularized scaffold product derived from keratinocytes grown on gelled collagen containing dermal fibroblasts.
STRATAGRAFT is an approximately 100 cm2 rectangular sheet (approximately 8 cm by 12.5 cm) . (NDC 73612-200-01), loosely adherent to a polycarbonate membrane within a polystyrene frame and packaged in a sealed foil pouch contained within a carton.
STRATAGRAFT is shipped on dry ice. The Hold Solution and Hold Dish are packaged separately and shipped at ambient temperature.
Storage And Handling
Store STRATAGRAFT between -70°C and -90°C (-94°F to -130°F).
Store the Hold Solution between 2°C and 8°C (36°F and 46°F).
Store Hold Dishes at ambient temperature.
Do not use any of the above components if they have been compromised.
Dispose of unused STRATAGRAFT as surgical biohazardous waste in accordance with local requirements.
Dispose of materials that have come into contact with STRATAGRAFT as surgical biohazardous waste in accordance with local requirements.
Contact Customer Care at 1-877-647-2239 for further instructions.
Manufactured by: Stratatech Corporation 510 Charmany Drive, Suite 150 Madison, WI 53719. Revised: Jan 2024.