ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025
The repair of large meningomyelocele defects using perforator artery-based non-island fasciocutaneous flaps.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe aim of this study is to evaluate the outcomes and complications of surgically closing myelomeningocele (MMC) defects in infants using perforator artery-based non-island fasciocutaneous flaps.
methodsBetween January 2022 and March 2024, 12 infants (8 girls and 4 boys) underwent closure surgery for MMC defects. All patients underwent surgery in the first 48 h after delivery. All newborn care, laboratory, and radiological values of patients who underwent surgery within 48 h after birth were performed. The surgery to be applied was determined according to the evaluations of plastic surgery, anesthesia clinic, and neurosurgery. All patients were evaluated in the newborn clinic, and their postoperative close follow-ups were conducted there. The surgical area was evaluated together by plastic surgery and neurosurgery.
resultsThe most frequent surgical flap problem was venous congestion in the flap's distal part (75% of instances, nine patients). Wound dehiscence occurred at the flap edge in 25% of our patients (three patients), in the T zone of the donor site in 20% (two patients), and on both sides in 5% (one patient), all of which were successfully treated without surgery. None of the patients developed hematomas, but seroma was seen in 10% of the donor regions. There was no flap loss or total necrosis. No patient had a reoperation due to flap-related problems. Our follow-up period was 4 months, and no late-stage problems (wound dehiscence or sinus) were detected. CONCLUSıON: We believe closing a MMC defect with a perforator artery-based non-island fasciocutaneous flap is a safe and successful procedure with low morbidity. The most common consequences are venous congestion and mild wound dehiscence, which are often addressed as non-surgical problems. Long-term follow-ups revealed no late problems.
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