DOUBLE ROTATION FASCIOCUTANEUS FLAP COVER FOR LARGE LUMBOSACRAL MENINGOMYELOCELE
Abstract
Meningomyelocele (MMC) is the most common form of spinal dysraphism. Closure of the meningomyelocele defect is a challenge and a variety of reconstructive options are described. Closure of the MMC is critical to prevent infection and neurological deterioration. Twenty five percent of the defects are wide defects which cannot be closed primarily. Meningomyelocele defects in the lower sacral area are more difficult to close than defects in the thoraco-lumbar area because the latissimus muscle is anatomically insufficient to provide total muscular coverage of the meninges in the sacral area. In a case of 4 month old baby with large Meningomyelocele, a double rotation fasciocutaneous flap with a minor modification to usual double rotation was applied for easy tension free closure of the defect and primary closure of the secondary defect. The vertical distal ends of the defect were closed primarily thus reducing the defect size and consequently a much smaller flap could be designed. A tension free easy closure in a short duration with less bleeding is the advantage of this technique.
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Mutaf M, Bekereciolu M, Erkutlu I, Bulut Ö. A New Technique for Closure of Large Meningomyelocele Defects: Ann Plast Surg. 2007 Nov;59(5):538–43.
Atik B, Tan O, Kymaz N, Ylmaz N, Tekes L. Bilobed Fasciocutaneous Flap Closure of Large Meningomyeloceles: Ann Plast Surg. 2006 May;56(5):562–4.
Çöloglu H, Özkan B, Uysal AÇ, Çöloglu Ö, Borman H. Bilateral Propeller Flap Closure of Large Meningomyelocele Defects. Ann Plast Surg. 2014;73(1):68–73.
LORENZO D. BOTTO., CYNTHIA A. MOORE, MUIN J. KHOURY, J. DAVID ERICKSON. NEURAL-TUBE DEFECT. N Engl J Med. 1999 Nov 11;341(20):1509–19.
Caldarelli M, Di Rocco C. Myelomeningocele primary repair surgical technique. The Spina Bifida [Internet]. Springer; 2008 [cited 2015 May 22]. p. 143–55. Available from: http://link.springer.com/chapter/10.1007/978-88-470 -0651-5_10
M. Memet Özek, Giuseppe Cinalli, Virginia Maixner. Spina Bifida: Management and Outcome.
Springer Science & Business Media, 2008; 2008.
Akcal A, Karsidag S, Görgülü T, Uurlu K. Delayed and nondelayed bilateral bipedicled fasciocutaneous flaps in large meningomyelocele defects: a preliminary results. ili Etfal Tp Bül. 2012;46(4):181–8.
Agag RL, Granick MS, Ganchi P, Datiashvilli R, Catrambone J. Repair of lumbosacral meningomyeloceles with acelluar cadaveric dermal matrix: an added layer of protection. Eplasty [Internet]. 2008 [cited 2015 May 22];8. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2224164/
Muskett A, Barber WH, Parent AD, Angel MF. Contemporary postnatal plastic surgical management of meningomyelocele. J Plast Reconstr Aesthet Surg. 2012 May;65(5):572–7.
Ghozlan NA, Eisa AM. Reconstruction of broad-based myelomeningocele defects: a modified technique. Egypt J Plast Reconstr Surg. 2007;31(2):213–9.
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