Reconstruction of large meningomiyelosel defects with bipedicled fasciocutaneous flaps: technical and clinical points

Abstract

AIM:To evaluate the bilateral vertical bipedicled procedure for the closure of large meningomyelocele defects and to emphasise some technical and clinical considerations. MATERIAL and METHODS:This procedure was used to close large meningomyelocele defects in ten patients (six males and four females) between January 2016 and August 2020. Eight of the patients were operated on within the first 24 hours of birth, and the remaining two were operated on between 1-7 days from birth. The average defect size was 6 x 9 cm (5 x 7 and 8 x 13 cm). The location of the lesions was thoracolumbar in two patients and lumbosacral in eight patients. Patient demographics, including sex, gestational age, birth weight, age at operation, defect size, duration of the operation, intraoperative-postoperative blood transfusion, length of hospital stay and complications, were evaluated. RESULTS:In all patients, closure was successful. Two patients required reoperation because of wound dehiscence, and healing was uneventful, without any complications. No patient experienced late breakdown of the wound during a mean follow-up period of 14.9 months (12-18 months).CONCLUSION: Bipedicled fasciocutaneous flaps can be used as an alternative method to repair large meningomyelocele defects due to their simple and reliable nature, which also causes less haemorrhage, and can be used in selected patients.