A Reliable Approach to the Closure of Large Acquired Midline Defects of the Back

Casas, Laurie A.; Lewis, Victor L.

doi:10.1097/00006534-198984040-00013

Cited by 60 publications

(45 citation statements)

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“…Based on the original classification by Casas and Lewis [5], wounds in the inferior posterior trunk (L1 to S5) are amenable to closure with latissimus, gluteus maximus or paraspinous muscle flaps. However, myofascial planes and vascular pedicles may not be well-developed in young children and, in those with MMC, may be abnormal due to previous surgery or abnormal development.…”

Section: Discussionmentioning

confidence: 99%

Myofascial Closure of Intradural Inclusion Cysts following in utero Myelomeningocele Repair

et al. 2015

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Myelomeningocele is one of the most common congenital malformations. A randomized controlled trial, known as the Management of Myelomeningocele Study (MOMS), demonstrated that closure during the fetal period can be performed relatively safely and be of significant benefit to patients. However, postnatally, patients can develop resultant symptoms from a tethered cord and inclusion cysts; this often requires surgical treatment. Repeat surgery in this population can be challenging due to the age of the patients, the extent of surgical exposure needed and the need for resection of dermal and epidermal tissues in the midline. We describe our approach for closure of these complex defects using lateral fasciocutaneous flaps with relaxing incisions made in the posterior axillary line, in order to minimize tension and maximize soft tissue coverage of the midline.

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Section: Discussionmentioning

confidence: 99%

Myofascial Closure of Intradural Inclusion Cysts following in utero Myelomeningocele Repair

et al. 2015

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“…Such wounds, especially when associated with exposed hardware represent a significant situation which may lead to spinal instability, inability to achieve erect posture, and neurological compromise. Moreover, the morbidity associated with complicated [5,16,29,30,31].…”

Section: Discussionmentioning

confidence: 99%

“…Delayed secondary healing and skin grafts can be useful for superficial sloughs but does not provide soft tissue cover over metallic implants [16]. Following prompt débridement in complex spinal wounds muscle or musculocutaneous flaps should be used to cover exposed metalwork, obliterate dead space, and ensure the best overall salvage and optimal function [5,16,25,29,30,31]. Muscle flaps are preferred to fasciocutaneous and skin flaps for salvage of orthopedic hardware, not only in the spine [17] but also elsewhere in the body; this includes knee prostheses [13], and shoulder implants [19].…”

Section: Discussionmentioning

confidence: 99%

“…Following this the antibiotic was changed according to culture sensitivity, and this was continued for 6 weeks. A systematic approach was adopted for the selection of local muscle flaps, as described previously by several authors [5,25]. intravenously every 6 h. Except in patient 4, the postoperative course was uneventful in all cases with the wounds being successfully closed primarily using local flaps (Figs.…”

Section: Methodsmentioning

confidence: 99%

“…However, such a conventional treatment for these infections is not always successful in achieving delayed primary wound closure. Therefore muscle or musculocutaneous flaps are necessary to accomplish early wound closure, and cover the exposed metalwork, thereby ensuring spinal stability [5,16,25,29,30,31].…”

Section: Introductionmentioning

confidence: 99%

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Immediate debridement and coverage of exposed spinal hardware with muscle flaps

Akyürek

Şafak

Alanay

et al. 2002

European Journal of Plastic Surgery

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We report the outcome of immediate débride-ment and soft tissue cover of spinal wounds secondary to exposure of orthopedic hardware, using local muscle or musculocutaneous flaps. Five patients were treated (mean age 18 years). Radical débridement was performed prior to flap closure. Depending on the location of the defect, a pedicled muscle or myocutaneous flap was selected, alone or in combination with latissimus dorsi, trapezius, gluteus maximus, or paraspinous muscles. The implants were successfully covered. The hardware was maintained until solid spinal fusion was achieved. We recommend early and definitive cover of exposed spinal fusion devices using local muscle or musculocutaneous flaps; the choice depends on the location of the defect. By this approach the wound can be effectively repaired with a well-vascularized muscle flap covering the hardware, thus obviating the need for its removal and thus ensuring spinal stability.

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Posterior trunk reconstruction with the dorsal intercostal artery perforator based flap: Clinical experience on 20 consecutive oncological cases

et al. 2015

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A Reliable Approach to the Closure of Large Acquired Midline Defects of the Back

Cited by 60 publications

References 0 publications

Myofascial Closure of Intradural Inclusion Cysts following in utero Myelomeningocele Repair

Myofascial Closure of Intradural Inclusion Cysts following in utero Myelomeningocele Repair

Immediate debridement and coverage of exposed spinal hardware with muscle flaps

Posterior trunk reconstruction with the dorsal intercostal artery perforator based flap: Clinical experience on 20 consecutive oncological cases

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