Cargando…

Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair

BACKGROUND: The global prevalence of myelomeningocele has been reported to be 0.8–1 per 1,000 live births. Early closure of the defect is considered to be the standard of care. Various surgical methods have been reported, such as primary skin closure, local skin flaps, musculocutaneous flaps, and sk...

Descripción completa

Detalles Bibliográficos
Autores principales: Shim, Jung-Hwan, Hwang, Na-Hyun, Yoon, Eul-Sik, Dhong, Eun-Sang, Kim, Deok-Woo, Kim, Sang-Dae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Plastic and Reconstructive Surgeons 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4738124/
https://www.ncbi.nlm.nih.gov/pubmed/26848442
http://dx.doi.org/10.5999/aps.2016.43.1.26
_version_ 1782413562393657344
author Shim, Jung-Hwan
Hwang, Na-Hyun
Yoon, Eul-Sik
Dhong, Eun-Sang
Kim, Deok-Woo
Kim, Sang-Dae
author_facet Shim, Jung-Hwan
Hwang, Na-Hyun
Yoon, Eul-Sik
Dhong, Eun-Sang
Kim, Deok-Woo
Kim, Sang-Dae
author_sort Shim, Jung-Hwan
collection PubMed
description BACKGROUND: The global prevalence of myelomeningocele has been reported to be 0.8–1 per 1,000 live births. Early closure of the defect is considered to be the standard of care. Various surgical methods have been reported, such as primary skin closure, local skin flaps, musculocutaneous flaps, and skin grafts. The aim of this study was to describe the clinical characteristics of myelomeningocele defects and present the surgical outcomes of recent cases of myelomeningocele at our institution. METHODS: Patients who underwent surgical closure of myelomeningocele at our institution from January 2004 to December 2013 were included in this study. A retrospective chart review of their medical records was performed, and comorbidities, defect size, location, surgical procedures, complications, and the final results were analyzed. RESULTS: A total of 14 patients underwent surgical closure for myelomeningocele defects. Twelve cases were closed with direct skin repair, while two cases required local skin flaps to cover the skin defects. Three cases of infection occurred, requiring incision and either drainage or removal of allogenic materials. One case of partial flap necrosis occurred, requiring secondary revision using a rotational flap and a full-thickness skin graft. Despite these complications, all wounds eventually healed completely. CONCLUSIONS: Most myelomeningocele defects can be managed by direct skin repair alone. In cases of large defects, in which direct repair is not possible, local flaps may be used to cover the defect. Complications such as wound dehiscence and partial flap necrosis occurred in this study; however, all such complications were successfully managed with simple ancillary procedures.
format Online
Article
Text
id pubmed-4738124
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher The Korean Society of Plastic and Reconstructive Surgeons
record_format MEDLINE/PubMed
spelling pubmed-47381242016-02-04 Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair Shim, Jung-Hwan Hwang, Na-Hyun Yoon, Eul-Sik Dhong, Eun-Sang Kim, Deok-Woo Kim, Sang-Dae Arch Plast Surg Original Article BACKGROUND: The global prevalence of myelomeningocele has been reported to be 0.8–1 per 1,000 live births. Early closure of the defect is considered to be the standard of care. Various surgical methods have been reported, such as primary skin closure, local skin flaps, musculocutaneous flaps, and skin grafts. The aim of this study was to describe the clinical characteristics of myelomeningocele defects and present the surgical outcomes of recent cases of myelomeningocele at our institution. METHODS: Patients who underwent surgical closure of myelomeningocele at our institution from January 2004 to December 2013 were included in this study. A retrospective chart review of their medical records was performed, and comorbidities, defect size, location, surgical procedures, complications, and the final results were analyzed. RESULTS: A total of 14 patients underwent surgical closure for myelomeningocele defects. Twelve cases were closed with direct skin repair, while two cases required local skin flaps to cover the skin defects. Three cases of infection occurred, requiring incision and either drainage or removal of allogenic materials. One case of partial flap necrosis occurred, requiring secondary revision using a rotational flap and a full-thickness skin graft. Despite these complications, all wounds eventually healed completely. CONCLUSIONS: Most myelomeningocele defects can be managed by direct skin repair alone. In cases of large defects, in which direct repair is not possible, local flaps may be used to cover the defect. Complications such as wound dehiscence and partial flap necrosis occurred in this study; however, all such complications were successfully managed with simple ancillary procedures. The Korean Society of Plastic and Reconstructive Surgeons 2016-01 2016-01-15 /pmc/articles/PMC4738124/ /pubmed/26848442 http://dx.doi.org/10.5999/aps.2016.43.1.26 Text en Copyright © 2016 The Korean Society of Plastic and Reconstructive Surgeons http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Shim, Jung-Hwan
Hwang, Na-Hyun
Yoon, Eul-Sik
Dhong, Eun-Sang
Kim, Deok-Woo
Kim, Sang-Dae
Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair
title Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair
title_full Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair
title_fullStr Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair
title_full_unstemmed Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair
title_short Closure of Myelomeningocele Defects Using a Limberg Flap or Direct Repair
title_sort closure of myelomeningocele defects using a limberg flap or direct repair
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4738124/
https://www.ncbi.nlm.nih.gov/pubmed/26848442
http://dx.doi.org/10.5999/aps.2016.43.1.26
work_keys_str_mv AT shimjunghwan closureofmyelomeningoceledefectsusingalimbergflapordirectrepair
AT hwangnahyun closureofmyelomeningoceledefectsusingalimbergflapordirectrepair
AT yooneulsik closureofmyelomeningoceledefectsusingalimbergflapordirectrepair
AT dhongeunsang closureofmyelomeningoceledefectsusingalimbergflapordirectrepair
AT kimdeokwoo closureofmyelomeningoceledefectsusingalimbergflapordirectrepair
AT kimsangdae closureofmyelomeningoceledefectsusingalimbergflapordirectrepair