Superior gluteal artery perforator flap for meningomyelocele defect: A saviour when other options vanish

Küçüker, İsmail; Sezgin, Billur; Tuncer, Serhan; Ayhan, Sühan

doi:10.4103/0970-0358.129660

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…5 Since then, its successful application to this problem and modification by other surgeons has been reported. 7,18 The primary indication for its use is a large defect (> 24 cm 2 ) that would be difficult to close without a complex reconstructive approach. In our series, major wound complications requiring revision surgery occurred in 18% (2 of 11) of patients.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of superior gluteal artery perforator flap closure of large myelomeningoceles

Whittemore¹,

Swift

Weprin

et al. 2017

PED

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OBJECTIVE Large myelomeningocele defects and poor surrounding tissue quality make some defects particularly difficult to close primarily. This paper describes the superior gluteal artery perforator (SGAP) flap technique for defect closure and long-term clinical outcomes. METHODS The technique for closing a myelomeningocele with an SGAP flap is described. A retrospective chart review was performed on a cohort of 11 patients who underwent closure in this manner. RESULTS Between 1999 and 2015, 271 myelomeningoceles were closed, 11 of which were SGAP flap closures. The mean defect size was 5.5 × 7.2 cm. All patients underwent ventriculoperitoneal shunting. There were no cases of CSF infection. Five patients had minor wound issues (small dehiscence or eschar formation) that healed satisfactorily. Two patients had soft-tissue wound infections and required multiple revisions; one patient had multiple severe developmental abnormalities, and the other patient's flap had healed with a thick underlying fat pad 4 months postoperatively. No patients had significant surgical site pain on long-term follow-up. CONCLUSIONS The SGAP flap technique achieves tension-free closure with vascularized, fat-bearing full-thickness skin. It is useful for closure of large, complex defects, is not associated with chronic pain, and carries a morbidity risk that is comparable to other complex myelomeningocele closure techniques.

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Section: Discussionmentioning

confidence: 99%

Long-term follow-up of superior gluteal artery perforator flap closure of large myelomeningoceles

Whittemore¹,

Swift

Weprin

et al. 2017

PED

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Keystone flap: a safe coverage option in the handling of salvage for myelomeningocele

Gómez

Barrera

2020

Childs Nerv Syst

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An Application of Keystone Perforator Island Flap for Closure of Lumbosacral Myelomeningocele Defects

Park

Morrison

et al. 2016

Annals of Plastic Surgery

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Myelomeningocele, also known as spina bifida, is the commonest form of neural tube defect in which both meninges and spinal cord herniate through a large vertebral defect. It may be located at any spinal level; however; lumbosacral involvement is most common. After birth, the closure of spinal lesion is preferably undertaken in the first 48 hours to minimize the risk of injury and central nervous system infection. Relatively small skin defects overlying the dural repair may be directly closed. However, larger defects require reconstructive closure. Numerous methods of reconstruction have been described, such as split skin graft, local flaps or lumbosacral fasciocutaneous flaps, muscle flaps using latissimus dorsi, gluteal or paraspinous muscles, and perforator flaps namely superior gluteal artery perforators, and dorsal intercostal artery perforator flaps. At Monash Health, Victoria, we have used the keystone perforator island flaps to reconstruct lumbosacral myelomeningocele defects on 5 newborns between January 2008 and January 2014. This article evaluates the short-term and long-term outcomes of these patients who were followed up for 10 to 66 months.

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Superior gluteal artery perforator flap for meningomyelocele defect: A saviour when other options vanish

Cited by 3 publications

References 5 publications

Long-term follow-up of superior gluteal artery perforator flap closure of large myelomeningoceles

Long-term follow-up of superior gluteal artery perforator flap closure of large myelomeningoceles

Keystone flap: a safe coverage option in the handling of salvage for myelomeningocele

An Application of Keystone Perforator Island Flap for Closure of Lumbosacral Myelomeningocele Defects

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