Bilateral split latissimus dorsi V–Y flaps for closure of large thoracolumbar meningomyelocele defects

Sarifakioglu, Nedim; Bingul, Ferruh; Terzioğlu, Ahmet; Ates, Levent; Aslan, Gürcan

doi:10.1016/s0007-1226(03)00115-2

Cited by 46 publications

(24 citation statements)

References 10 publications

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“…4,5 Several surgical techniques have been proposed for softtissue closure of various spinal defects, including primary closure, split-thickness skin grafts, local skin flaps, muscle flaps, and composite flaps such as fasciocutaneous or myocutaneous flaps. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] All techniques aim to provide durable, tension-free, and watertight closure with well-vascularized tissue in an attempt to reduce the complication rate. However, most flaps are inapt for reconstruction of large defects located in the lumbosacral area.…”

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confidence: 99%

Paravertebral Turnover Flaps for Closure of Large Spinal Defects Following Tethered Cord Repair

Arad¹,

Barnea²,

Gur³

et al. 2006

Annals of Plastic Surgery

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Reconstruction of large congenital spinal defects remains a challenge. We present our experience in closure of difficult spinal defects following repair of tethered cord, using paravertebral fascial or myofascial turnover flaps. Between 1996 and 2005, 23 patients were operated using paravertebral turnover flaps for closure of large spinal defects associated with tethered cord. Fifteen (65%) patients had lipomyelomeningoceles. Eleven (48%) patients had sacral defects, 10 (43%) had lumbosacral defects, and 2 (9%) had lumbar defects. Fourteen (61%) patients underwent closure using fascial turnover flaps. Myofascial turnover flaps were used in 9 (39%) patients. Following surgery, none of the patients developed cerebrospinal fluid (CSF) leaks, pseudomeningoceles, or subcutaneous infection. One patient suffered superficial necrosis and infection of the skin suture line, which healed secondarily. We conclude that fascial or myofascial paravertebral turnover flaps provide reliable coverage of difficult defects of the spinal CNS.

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mentioning

confidence: 99%

Paravertebral Turnover Flaps for Closure of Large Spinal Defects Following Tethered Cord Repair

Arad¹,

Barnea²,

Gur³

et al. 2006

Annals of Plastic Surgery

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“…In this fashion, a sheet of muscle can then be flapped down over the entire defect and sewn in place with 2-0 vicryl. There are many reports of complex plastic surgical closures in the literature; 4,5,7,10 however, at our institution we have found that closures of even the largest defects ( Fig. 2) can be effectively performed by the neurosurgeon when using the above techniques.…”

mentioning

confidence: 67%

Primary closure of open myelomeningocele

Gaskill¹

2004

FOC

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Object The purpose of this paper is to describe the technique of closing an open myelomeningocele in the newborn infant. Methods The anatomical rationale behind the closure techniques will be specifically reviewed. Avoidance of complications will be discussed. The management of unusual developmental anatomical abnormalities, such as the management of unusually large skin defects and kyphotic deformities will be discussed. Complications and the postoperative care will be reviewed and specifics regarding postoperative care will be summarized. Conclusions A multidisciplinary team approach is critical to the long-term management of these patients.

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“…The presence of congenital kyphosis, a curvature of the spine that creates a bowing of the back, complicates the repair process. 57,58 Kyphosis will be discussed in a future article in the series.…”

Section: Sidebar 2 Intrauterine Repair Of Myelomeningocelementioning

confidence: 99%

Part 2

Mc¹

2006

Advances in Neonatal Care

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Spinal dysraphism includes a constellation of frequent and potentially complex malformations of the spine and spinal cord. Open spinal dysraphisms, the majority of which are myelomeningoceles, have a number of associated morbidities that require both immediate and lifelong medical care. The role of the neonatal nurse includes the immediate stabilization of the affected infant, systematic examination of the malformation, and implementation of evidence-based protocols to ameliorate the associated medical problems. Coordination of care and communication and support of the family are essential aspects of care. This article reviews the embryology of open spinal dysraphisms and the steps needed to stabilize and evaluate affected infants.

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Bilateral split latissimus dorsi V–Y flaps for closure of large thoracolumbar meningomyelocele defects

Cited by 46 publications

References 10 publications

Paravertebral Turnover Flaps for Closure of Large Spinal Defects Following Tethered Cord Repair

Paravertebral Turnover Flaps for Closure of Large Spinal Defects Following Tethered Cord Repair

Primary closure of open myelomeningocele

Part 2

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