Name of the Procedure:

Amniotic Membrane for Surgical Reconstruction (HCPCS Code: V2790)

Common Name(s): Amniotic Membrane Graft, AmnioGraft

Technical or Medical Term: Amniotic Membrane Transplantation

Summary

Amniotic membrane transplantation involves using tissue from the innermost layer of the placenta to repair or regenerate damaged tissue. This graft helps promote healing and reduce inflammation in a variety of surgical settings.

Purpose

The procedure is utilized to address various medical issues, including tissue repair, chronic wounds, burns, and eye surface reconstruction. The primary goals are to enhance healing, reduce scarring, and minimize inflammation.

Indications

• Chronic non-healing wounds
• Severe burns
• Ocular surface diseases like pterygium or corneal ulcers
• Reconstructive surgery after trauma or infection
• Soft tissue defects

Patients who have conditions that require enhanced healing and tissue regeneration may be candidates for this procedure.

Preparation

• Pre-procedure fasting for at least 6-8 hours if general anesthesia is used.
• Adjustments in medication as advised by the healthcare provider.
• Pre-procedure diagnostic tests such as blood work or imaging to evaluate the extent of tissue damage.
• Ensuring no active infections are present.

Procedure Description

1. The patient is prepared and appropriately draped in a sterile environment.
2. Anesthesia is administered, which could be local, regional, or general, depending on the procedure and location.
3. The damaged or defective tissue area is cleaned and prepped.
4. The amniotic membrane graft is carefully positioned over the affected area.
5. The graft is secured using sutures, adhesives, or other fixation methods.
6. The area is then dressed and protected.

Tools: Scalpels, sutures, tissue adhesive, amniotic membrane graft

Duration

The procedure typically lasts from 30 minutes to a few hours, depending on the complexity and location of the tissue repair.

Setting

The procedure is performed in either a hospital operating room, minor procedure room, or outpatient surgical center.

Personnel

• Surgeon
• Surgical Nurse
• Anesthesiologist (if general or regional anesthesia is used)
• Scrub Technician

Risks and Complications

• Infection at the graft site
• Rejection of the graft tissue
• Scarring or adhesion formation
• Bleeding or hematoma
• In rare cases, allergic reaction to anesthesia or graft material

Benefits

• Enhanced and accelerated healing
• Reduced inflammation and pain
• Lower risk of scarring compared to traditional methods
• Potential to save or repair significant areas of damaged tissue

Benefits are often noticeable within days to weeks post-procedure, depending on the specific condition treated.

Recovery

• Keep the treatment area clean and dry.
• Follow prescribed wound care instructions.
• Take prescribed antibiotics or pain medications as directed.
• Avoid strenuous activities until cleared by the healthcare provider.
• Follow-up appointments to monitor healing progress.

Expected recovery time varies but typically ranges from several weeks to a few months, depending on the condition and patient's overall health.

Alternatives

• Skin grafts for surface wounds or burns
• Synthetic graft materials
• Stem cell therapy
• Debridement alone for chronic wounds

Pros and Cons: Amniotic membrane grafts offer enhanced healing with lower risks of rejection compared to synthetic materials but may be more expensive and require coordination for obtaining the graft material.

Patient Experience

During the procedure, if local anesthesia is used, the patient might feel minor discomfort or pressure but usually no pain. After the procedure, patients might experience mild pain, swelling, and redness at the graft site, which can be managed with prescribed medications. Most patients feel an improvement in their condition within a few days to weeks.