Reconstruction of large meningomyelocele defects with rotation-transposition fasciocutaneous flaps
Autor: | Birol Civelek, Emin Kapi, Samet Vasfi Kuvat, Mehmet Bozkurt, Caferi Tayyar Selçuk |
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Rok vydání: | 2011 |
Předmět: |
Male
medicine.medical_specialty Meningomyelocele business.industry Defect reconstruction Kyphosis Infant Newborn Infant Neural tissues Plastic Surgery Procedures medicine.disease Surgical Flaps Surgery Transposition (music) Treatment Outcome Blood loss Medicine Humans In patient Female Surgical treatment business Short duration |
Zdroj: | Annals of plastic surgery. 69(2) |
ISSN: | 1536-3708 |
Popis: | Meningomyelocele is one of the most common congenital defects of the central nervous system. Reconstruction of these defects must be performed immediately after delivery to prevent complications such as primary meningitis and to protect the neural tissues. The most important factors in the surgical treatment of meningomyelocele defects are the size of the defect, its location, the presence of kyphosis, and the quality of the surrounding tissue. The chosen method must be a simple one that causes minimal blood loss, requires a short duration of surgery, and covers the surface of the neural defect with a soft-tissue mass enabling closure without tension. In our study, satisfactory results have been obtained using 1 or 2 fasciocutaneous flaps based on the midline in 20 patients with large meningomyelocele defects where primary closure was not possible. A single flap based superiorly on the midline was sufficient to close the defects in patients without kyphosis. In patients with concurrent kyphosis, a second flap based inferiorly on the midline has been used. All flaps survived, except for a distal partial necrosis observed in 1 patient. In the method we used, we adopted a defect reconstruction that is similar to the normal anatomic structures and resistant to trauma and infections, and does not sacrifice any muscle tissue. According to our clinical experiences, this method is useful for large meningomyelocele defects that are unsuitable for primary closure. |
Databáze: | OpenAIRE |
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