Name of the Procedure:

Common Name(s): Acellular Pericardial Tissue Graft
Technical/Medical Term: Acellular Pericardial Tissue Matrix of Non-Human Origin (Veritas), per square centimeter (C9354)

Summary

Acellular Pericardial Tissue Matrix (Veritas) is a graft derived from non-human sources (commonly bovine or porcine) used to repair or replace damaged tissue. This graft has been processed to remove all living cells, reducing the risk of rejection, and is applied to wounds or surgical sites to support healing and tissue regeneration.

Purpose

Medical Conditions Addressed:
This graft is used in the repair of hernias, wound closure, soft tissue reinforcement, and reconstructive surgeries.
Goals/Outcomes:
The procedure aims to provide a scaffold for natural tissue growth, reduce healing time, minimize infection risk, and improve overall wound or surgical site healing.

Indications

• Chronic or complex wounds.
• Hernia repairs, especially large or recurrent hernias.
• Soft tissue reconstruction following traumatic injury or surgical removal of tissue.
• Patients requiring tissue reinforcement due to insufficient native tissue.

Preparation

• Patients may be required to fast for a certain period before the procedure.
• Medication adjustments may be necessary, especially anticoagulants.
• Preoperative diagnostic tests, such as blood work and imaging, may be conducted to assess the patient’s overall health and the specific area requiring repair.

Procedure Description

1. Anesthesia: The patient is usually administered local or general anesthesia depending on the extent of the surgery.
2. Incision: The surgeon makes an incision at the site requiring repair or reconstruction.
3. Preparation of Graft: The acellular pericardial tissue matrix is prepared and trimmed to the required size.
4. Placement: The tissue matrix is placed over the damaged area and secured with sutures or surgical staples.
5. Closure: The incision site is then closed, typically with sutures or surgical staples, and dressed appropriately.

Duration

The procedure typically takes between 1-3 hours, depending on the complexity and extent of the repair.

Setting

This procedure is generally performed in a hospital operating room or a specialized surgical center.

Personnel

• Surgeon: Performs the procedure.
• Nurses: Assist with the surgery and provide perioperative care.
• Anesthesiologist: Manages anesthesia and monitors the patient’s vital signs during the procedure.

Risks and Complications

• Common Risks: Infection, bleeding, and adverse reactions to anesthesia.
• Rare Risks: Graft rejection, delayed wound healing, and chronic pain.
• Management: Postoperative antibiotics, careful monitoring, and, in some cases, additional surgical intervention may be required.

Benefits

• Promotes faster and more effective wound healing.
• Reduces the risk of infection compared to other types of grafts.
• Provides a durable and robust scaffold for tissue regeneration.

Realization Time: Benefits often become apparent within a few weeks to a few months, depending on the site and extent of the repair.

Recovery

• Post-procedure Care: Application of dressings, instructions on wound care, and medication management for pain and infection prevention.
• Expected Recovery Time: Generally, full recovery can take from several weeks to a few months.
• Restrictions: Patients may be advised to avoid strenuous activities for a period and attend follow-up appointments to monitor healing.

Alternatives

• Synthetic grafts: Made from artificial materials.
• Autologous tissue grafts: Using the patient’s own tissue.
• Pros and Cons: Synthetic grafts can sometimes lead to more complications and less integration, whereas autologous tissue grafts pose no rejection risk but can entail more extensive surgery and donor site morbidity.

Patient Experience

During the procedure, the patient will be under anesthesia and will not feel anything. Post-procedure, patients might experience some discomfort or pain at the surgical site, which can be managed with prescribed pain medications. Proper wound care instructions will be provided to ensure comfort and optimal recovery.