Can Amniotic Membrane Graft Have An Impact In Lower Extremity Surgery?

While there are a number of membrane and skin grafts on the market, many do not provide podiatric surgeons with the versatile, nourishing and regenerative properties found in Neox™ amniotic membrane grafts, according to the manufacturer Amniox Medical.

   The company explains that most processes for amniotic membrane grafts entail dehydrating the membrane. Amniox utilizes Cryotek™technology, a deep cycle freezing that preserves the functional and structural integrity of the amniotic membrane graft. Amniox Medical notes that its Neox cryopreserved amniotic membrane grafts utilize a number of growth factors to guide tissue healing down a regenerative pathway.

   Alan R. Catanzariti, DPM, notes that Neox graft’s elite regenerative factors have been exceptional in guiding regional tissue growth. According to Dr. Catanzariti, who uses the Neox graft primarily for musculoskeletal repairs, the thin membrane provides an ideal environment for a smooth, resilient and easy repair with very little “bulk,” especially when surgeons use it to augment tendon repair.

   In the time he has been using the Neox graft, Dr. Catanzariti has had no issues of graft rejection. Neox is an exceptional product to cover raw bony surfaces to prevent adhesions as well as degenerative areas of joints with absent cartilage, notes Dr. Catanzariti, the Director of Residency Training and Chief of the Division of Foot and Ankle Surgery at the Western Pennsylvania Hospital in Pittsburgh.

   Christopher Hyer, DPM, has been using the Neox graft for more than a year and says he is very impressed with the results. Dr. Hyer primarily uses the graft in tendon repairs (Achilles and peroneal tears) as well as work involving joint capsules.

   “In addition, I have found (the graft) useful to prevent adhesive and hypertrophic scars for better cosmetic results but also when incisions are near nerves like in tarsal tunnel releases,” explains Dr. Hyer, a Fellow of the American College of Foot and Ankle Surgeons.

   Additionally, Dr. Hyer notes the Neox graft’s greatest advantage is how “quiet” it makes the healing process with decreased inflammatory response at the site translating to less pain, swelling and scarring.

   Michael Bednarz, DPM, highlights the graft’s anti-inflammatory properties. Other allografts may cause an inflammatory reaction that prolongs healing but with Neox, there is little to no inflammation on the wound bed, adds Dr. Bednarz, who is in private practice at the Ankle and Foot Centers of Georgia.

   Both Drs. Hyer and Catanzariti note they have not used the Neox graft as a skin graft. However, Dr. Bednarz often uses the graft in limb salvage techniques for patients who have suffered skin and tissue loss. Thus far, Dr. Bednarz says he has only used the Neox graft for wound closure and has not yet utilized the graft for hallux limitus or tendon repair.

   “I feel that Neox is superior because it is preserved cryogenically, which retains all the healing components in the graft,” adds Dr. Bednarz. “It is a sterile product and is very easy to handle and use. It is the only product that I have used that demonstrates wound contraction in the first postoperative week.”

   Although Drs. Hyer, Catanzariti and Bednarz utilize Neox amniotic membrane grafts in different procedures, all three DPMs note the graft’s exceptional ease of use, effectiveness and nourishing properties.

   For further reading, see “The Top Ten Innovations In Podiatry” in the August 2012 issue of Podiatry Today or “Could Human Amniotic Membrane Have An Impact In Hallux Limitus Procedures?” in the July 2012 issue.