Clinical Outcomes of Large Meningomyelocele Defect Repair by Bilateral Fasciocutaneous Rotation and Advancement Flaps with Perforators
Objective: Neural tube defects occur in approximately one in 1000 live births in the US. Myelomeningocele (MMC) is the most common and severe form of spina bifida aperta. In this study, we present a surgical modification of the bilateral fasciocutaneous rotation and advancement flap technique in...
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Wolters Kluwer Medknow Publications
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doaj-80738961f05d465e999b766d2b34831f2020-11-24T20:50:10ZengWolters Kluwer Medknow PublicationsTurkish Journal of Plastic Surgery2528-86442017-09-0125311311910.5152/TurkJPlastSurg.2017.2144Clinical Outcomes of Large Meningomyelocele Defect Repair by Bilateral Fasciocutaneous Rotation and Advancement Flaps with PerforatorsMustafa Kürşat Evrenos0Haldun Onuralp Kamburoğlu1Mehmet Seçer2Kadir Çınar3Mehmet Dadacı4Bilsev İnce5Department of Plastic, Reconstructive and Aesthetic Surgery, Celal Bayar University School of Medicine, Manisa, TurkeyDepartment of Plastic, Reconstructive and Aesthetic Surgery, Hacettepe University School of Medicine, Ankara, TurkeyDepartment of Plastic, Reconstructive and Aesthetic Surgery, Hacettepe University School of Medicine, Ankara, TurkeyClinic of Neurosurgery, Private Sani Konukoğlu Hospital, Gaziantep, TurkeyDepartment of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University School of Medicine, Konya, TurkeyDepartment of Plastic, Reconstructive and Aesthetic Surgery, Necmettin Erbakan University School of Medicine, Konya, TurkeyObjective: Neural tube defects occur in approximately one in 1000 live births in the US. Myelomeningocele (MMC) is the most common and severe form of spina bifida aperta. In this study, we present a surgical modification of the bilateral fasciocutaneous rotation and advancement flap technique in MMC patients. Material and Methods: Twenty-four patients (12 male, 12 female) with MMC who were operated on between August 2011 and June 2013 were retrospectively evaluated. Presence of hydrocephalus, the neurological status, and the level and size of the MMC were recorded. We used bilateral perforator-based fasciocutaneous rotation and advancement flaps for defects larger than 3 cm in width, or in the presence of prominent kyphosis together with any defect size. Results: The follow-up period ranged from eight days to two years. One patient died on the eighth day after surgery because of sepsis secondary to aspiration pneumonia. One patient had cerebrospinal fluid accumulation under the repair zone. In another patient, cerebrospinal fluid leakage through the repaired incision was observed on the ninth day after surgery. Three patients had minimal wound dehiscence at the distal end of the suture line. Conclusion: In this study, 24 patients were treated with the described perforator-based technique by preserving at least one perforator vessel on each side. Reconstruction of MMC defects with paraspinal fasciocutaneous rotation and advancement flaps is still one of the best choices for closing moderate-to-large defects without using skin graft, and the safety of the flaps increases by preserving the perforators.http://turkjplastsurg.org/sayilar/82/buyuk/113-1191.pdfMyelomeningocelemeningomyelocelefasciocutaneous flapperforator flap |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mustafa Kürşat Evrenos Haldun Onuralp Kamburoğlu Mehmet Seçer Kadir Çınar Mehmet Dadacı Bilsev İnce |
spellingShingle |
Mustafa Kürşat Evrenos Haldun Onuralp Kamburoğlu Mehmet Seçer Kadir Çınar Mehmet Dadacı Bilsev İnce Clinical Outcomes of Large Meningomyelocele Defect Repair by Bilateral Fasciocutaneous Rotation and Advancement Flaps with Perforators Turkish Journal of Plastic Surgery Myelomeningocele meningomyelocele fasciocutaneous flap perforator flap |
author_facet |
Mustafa Kürşat Evrenos Haldun Onuralp Kamburoğlu Mehmet Seçer Kadir Çınar Mehmet Dadacı Bilsev İnce |
author_sort |
Mustafa Kürşat Evrenos |
title |
Clinical Outcomes of Large Meningomyelocele Defect Repair by Bilateral Fasciocutaneous Rotation and Advancement Flaps with Perforators |
title_short |
Clinical Outcomes of Large Meningomyelocele Defect Repair by Bilateral Fasciocutaneous Rotation and Advancement Flaps with Perforators |
title_full |
Clinical Outcomes of Large Meningomyelocele Defect Repair by Bilateral Fasciocutaneous Rotation and Advancement Flaps with Perforators |
title_fullStr |
Clinical Outcomes of Large Meningomyelocele Defect Repair by Bilateral Fasciocutaneous Rotation and Advancement Flaps with Perforators |
title_full_unstemmed |
Clinical Outcomes of Large Meningomyelocele Defect Repair by Bilateral Fasciocutaneous Rotation and Advancement Flaps with Perforators |
title_sort |
clinical outcomes of large meningomyelocele defect repair by bilateral fasciocutaneous rotation and advancement flaps with perforators |
publisher |
Wolters Kluwer Medknow Publications |
series |
Turkish Journal of Plastic Surgery |
issn |
2528-8644 |
publishDate |
2017-09-01 |
description |
Objective: Neural tube defects occur in approximately one in 1000
live births in the US. Myelomeningocele (MMC) is the most common
and severe form of spina bifida aperta. In this study, we present a surgical
modification of the bilateral fasciocutaneous rotation and advancement
flap technique in MMC patients.
Material and Methods: Twenty-four patients (12 male, 12 female)
with MMC who were operated on between August 2011 and June
2013 were retrospectively evaluated. Presence of hydrocephalus, the
neurological status, and the level and size of the MMC were recorded.
We used bilateral perforator-based fasciocutaneous rotation and
advancement flaps for defects larger than 3 cm in width, or in the
presence of prominent kyphosis together with any defect size.
Results: The follow-up period ranged from eight days to two years.
One patient died on the eighth day after surgery because of sepsis
secondary to aspiration pneumonia. One patient had cerebrospinal
fluid accumulation under the repair zone. In another patient, cerebrospinal
fluid leakage through the repaired incision was observed
on the ninth day after surgery. Three patients had minimal wound
dehiscence at the distal end of the suture line.
Conclusion: In this study, 24 patients were treated with the described
perforator-based technique by preserving at least one perforator vessel
on each side. Reconstruction of MMC defects with paraspinal fasciocutaneous
rotation and advancement flaps is still one of the best
choices for closing moderate-to-large defects without using skin graft,
and the safety of the flaps increases by preserving the perforators. |
topic |
Myelomeningocele meningomyelocele fasciocutaneous flap perforator flap |
url |
http://turkjplastsurg.org/sayilar/82/buyuk/113-1191.pdf |
work_keys_str_mv |
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