Extended Transverse-oblique Back Flap for Myelomeningocele Defect Closure: A Case Series of 10 Patients

Kattan, Abdullah E; Al-Sufayan, F; Alammar, Alwaleed K; Alhazmi, Bushra; Ahmed, Albanderi; Gelidan, Adnan G.; Almishal, Obaid

doi:10.1097/gox.0000000000003095

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…Furthermore, cases with large skin defects or cases with kyphosis of the spine require coverage of a large area, making reconstruction even more difficult. Numerous flap techniques have been described to repair meningomyelocele with soft tissue defects, but the optimal surgical technique is still being debated [ 3 , 4 ]. Here, we report on the reconstruction of soft tissue in myelomeningocele performed at our hospital using a bilateral bipedicle flap and artificial dermal covering for the donor area of the flap.…”

Section: Introductionmentioning

confidence: 99%

Combining a Bilateral Bipedicle Flap and Artificial Dermis for Extensive Coverage in Meningomyelocele Surgery

Oshima,

Sasaki,

Aihara

et al. 2023

Cureus

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Myelomeningoceles with soft tissue defects are often difficult to close primarily and require reconstructive surgery. Furthermore, cases with large skin defects or cases with kyphosis of the spine require a large area to be covered, making reconstruction even more difficult. We performed closure of soft tissue defects using a bilateral bipedicle flap and application of artificial dermis to the flap donor area in three cases in which surgery was difficult. The bilateral bipedicle flap was able to easily and reliably close the soft tissue defect even in highly difficult emergency myelomeningocele surgery. We believe that applying artificial dermis to the flap donor area is a useful method that avoids autologous skin grafting and facilitates wound management. There have been no cases of major donor wound contracture. The healing period of the flap donor area may be predicted to some extent by the width immediately after surgery.

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Section: Introductionmentioning

confidence: 99%

Combining a Bilateral Bipedicle Flap and Artificial Dermis for Extensive Coverage in Meningomyelocele Surgery

Oshima,

Sasaki,

Aihara

et al. 2023

Cureus

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Dehydrated human amnion/chorion membrane allografts for myelomeningocele and wound reconstruction

Chen¹,

Lopez²,

Girard³

et al. 2021

Childs Nerv Syst

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Meningosel ve miyelomeningosel nedeni ile opere edilen 0-1 yaş çocuklarda sentetik dura ile otolog dura kullanımının komplikasyon gelişimi açısından karşılaştırılması

2023

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Abstract: Aim: The aim of this study is to compare the usage of synthetic and autologous dura mater in terms of complication risk in 0-1-year-old children who were operated for meningocele and myelomeningocele. Material and Methods: This cross-sectional observational study was conducted with 44 children aged 0-1 years who were operated for meningocele and myelomeningocele in a university hospital neurosurgery clinic between November 2010 and December 2016. Patient data were extracted retrospectively from hospital records. The demographics and gestational and clinical features of the mothers and babies, and the need for secondary surgery and the presence of postoperative infection, necrosis, wound dehiscence, and/or neurological deficit were compared between the cases who synthetic dura mater was used in their surgery and those autologous dura was used in their surgery. Results: In total, 86.4% of the 44 infants were preterm, and the predominant neurological problem was plegia in the vast majority. While the defect was located in the lumbar region in more than half of them, myelomeningocele was detected in 77.3% of all cases. The median defect size detected in the patients was 20.0 cm2, primary closure was performed in 30 patients, Limberg flap procedure in 14 patients, however, autologous dura mater and synthetic dura mater were used equally in the patients. The defect size was larger in patients using synthetic dura, furthermore hydrocephalus was found more frequently in these patients. While primary closure was applied in all patients using autologous dura and in one third of the patients using synthetic dura, Limberg flap procedure was applied in two thirds of synthetic dura group. The need for secondary surgery developed more frequently in synthetic dura group, and all postoperative complications were observed more frequently in these patients. In addition, the need for secondary surgery and postoperative necrosis, wound dehiscence, and neurologic deficit are more frequent in patients who underwent Limber flap compared to primary closure. However, the need for secondary surgery and the risk of postoperative complications were similar between primary closure and Limberg flap procedures in synthetic dura group. Conclusion: Although the synthetic dura mater was used in more severe patients, it had a higher need for secondary surgery and a higher risk of complications compared to autologous dura. In patients using synthetic dura, on the other hand, primary closure and Limberg flap had similar efficacy and safety.

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Extended Transverse-oblique Back Flap for Myelomeningocele Defect Closure: A Case Series of 10 Patients

Cited by 3 publications

References 18 publications

Combining a Bilateral Bipedicle Flap and Artificial Dermis for Extensive Coverage in Meningomyelocele Surgery

Combining a Bilateral Bipedicle Flap and Artificial Dermis for Extensive Coverage in Meningomyelocele Surgery

Dehydrated human amnion/chorion membrane allografts for myelomeningocele and wound reconstruction

Meningosel ve miyelomeningosel nedeni ile opere edilen 0-1 yaş çocuklarda sentetik dura ile otolog dura kullanımının komplikasyon gelişimi açısından karşılaştırılması

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