Name of the Procedure:

Microporous collagen implantable slit tube (NeuraWrap® nerve protector), per centimeter length (HCPCS Code: C9353)

Summary

The microporous collagen implantable slit tube, commonly known as NeuraWrap® nerve protector, is a medical device used to aid in the repair and protection of injured nerves. It provides a supportive environment to promote natural nerve healing by encasing the damaged nerve within a collagen-based tube.

Purpose

This procedure is primarily used to treat nerve injuries. The goals are to protect the nerve from external factors, promote natural healing, and prevent the formation of scar tissue which can impede nerve regeneration.

Indications

• Traumatic nerve injuries
• Nerve lacerations or transections
• Nerve compressions
• Nerve graft procedures

Patient criteria for this procedure typically include individuals with identifiable nerve damage that requires surgical intervention for optimal recovery.

Preparation

• The patient may need to fast for a certain period before the procedure, as advised by the surgeon.
• Medication adjustments may be necessary, especially if the patient is on blood thinners.
• Pre-procedure diagnostic tests such as nerve conduction studies or imaging to assess the extent of nerve damage.

Procedure Description

1. The patient is placed under local or general anesthesia.
2. An incision is made at the site of the nerve injury.
3. The damaged nerve is identified and carefully isolated.
4. The NeuraWrap® nerve protector is sized and trimmed to the appropriate length.
5. The nerve is gently guided into the slit tube, which then encases it.
6. The incision is closed, and the area is dressed appropriately.

Tools and equipment typically include surgical scissors, forceps, and the NeuraWrap® nerve protector itself.

Duration

The procedure typically lasts between 1 to 2 hours, depending on the complexity of the nerve injury.

Setting

The procedure is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

• Surgeons
• Surgical nurses
• Anesthesiologists
• Operating room technicians

Risks and Complications

• Infection at the surgical site
• Allergic reaction to the collagen implant
• Incomplete or failed nerve regeneration
• Scar tissue formation
• Temporary or permanent loss of nerve function
• Pain at the incision site

Benefits

• Facilitates natural nerve healing
• Reduces the risk of scar tissue interfering with nerve regeneration
• Structurally supports the damaged nerve
• Potential for improved functional recovery of the nerve

Patients may start noticing benefits several weeks to months after the procedure, as nerve regeneration is a gradual process.

Recovery

• Post-procedure care includes keeping the incision site clean and dry, managing pain with prescribed medications, and attending physical therapy if recommended.
• Full recovery time can vary but generally ranges from several weeks to months.
• Follow-up appointments are necessary to monitor healing and nerve function.

Alternatives

• Direct nerve repair without protective devices
• Nerve grafting, using a segment of nerve harvested from another part of the body
• Synthetic nerve conduits
• Conservative management with physical therapy

Each alternative has its pros and cons, with varying success rates and potential for different complications.

Patient Experience

During the procedure, patients will be under anesthesia and should not feel pain. Post-procedure, patients may experience discomfort or pain at the incision site, which is typically managed with pain medications. Swelling and bruising are common but should subside within a few days. Adherence to recovery guidelines and any physical therapy can greatly enhance the healing process and overall experience.