Fascia lata graft; by incision and area exposure, complex or sheet
CPT4 code
Name of the Procedure:
Fascia Lata Graft
Common name: Fascia Lata Harvest
Technical terms: Fascia Lata Graft by Incision and Area Exposure, Complex or Sheet
Summary
A fascia lata graft involves harvesting a piece of the fascia lata, a connective tissue layer in the thigh, to use in reconstructive procedures elsewhere in the body. This can involve a more complex or sheet-like technique depending on the need.
Purpose
The procedure addresses the need for robust, durable tissue to repair or reinforce other anatomical structures. The goals are to provide structural support, enhance healing, and improve function in the area receiving the graft.
Indications
- Severe tendon or ligament injuries
- Complex reconstructive surgeries
- Chronic instability in joints
- Previous surgical failures requiring additional support
- Specific areas of tissue deficiency
Preparation
- Fasting for at least 8 hours before surgery if general anesthesia will be used.
- Adjustments of medications as advised by the doctor, particularly blood thinners.
- Preoperative imaging or diagnostic tests to assess the graft donor and recipient sites.
- Blood tests and physical examination.
Procedure Description
- Anesthesia: The patient is given general anesthesia or regional anesthesia with sedation.
- Incision: A surgical incision is made at the outer side of the thigh to expose the fascia lata.
- Harvesting: A segment of the fascia lata is carefully removed, either as a complex strip or as a flat sheet, depending on surgical requirements.
- Graft Preparation: The harvested tissue is then prepared and shaped to fit the recipient site.
- Closure: The incision site on the thigh is sutured closed, often with the placement of drains to prevent fluid accumulation.
- Application: The fascia lata graft is applied to the recipient site where it is secured using surgical techniques appropriate for that specific area.
Duration
The procedure typically takes about 1 to 2 hours, but this can vary depending on the complexity and specific surgical needs.
Setting
The procedure is performed in a hospital operating room or a surgical center under sterile conditions.
Personnel
- Orthopedic or plastic surgeon specialized in reconstructive procedures
- Surgical nurses
- Anesthesiologist
- Surgical technician
Risks and Complications
- Infection at the donor or recipient site
- Bleeding or hematoma formation
- Scarring at the incision site
- Temporary or permanent nerve damage
- Graft failure or rejection
- Complications related to anesthesia
Benefits
- Provides strong, durable tissue for repair and reconstruction
- Enhances structural integrity and function of the repaired area
- Promotes better healing outcomes
- Immediate and long-term improvements in stability and mobility
Recovery
- Post-procedure monitoring in recovery room
- Pain management with medications
- Instructions to keep the donor site clean and dry
- Limited mobility of the affected leg for a specified period
- Regular follow-up appointments to monitor healing
- Physical therapy may be recommended for recovery
Alternatives
- Synthetic graft materials
- Cadaveric (donor) grafts
- Autologous grafts from different donor sites
Non-surgical treatments such as physiotherapy (though these may not be suitable for severe cases)
Pros of alternatives: Less invasive, potentially quicker recovery.
Cons: May be less durable or effective in some cases, risk of rejection with cadaveric grafts.
Patient Experience
During the procedure, the patient will be under anesthesia and should not feel any discomfort. Post-procedure, there may be pain and soreness at the incision site which can be managed with pain medications. Swelling and bruising are common and should subside within a few weeks. The patient may also experience limited mobility initially and will need to follow rehabilitation protocols to regain full function.