Türk Nöroşirürji Dergisi 2004 , Vol 14 , Num 1
EVALUATION OF SURGICAL TECHNIQUES USED FOR THE COVERAGE OF SKIN DEFECTS RESULTING FROM NEURAL DEFECT REPAIR IN MYELOMENINGOCELE CASES
Ahmet TERZİOĞLU1, Nedim SARIFAKIOĞLU1, Ferruh BİNGÜL1, Yavuz ERDEM2, Levent ATEŞ1, Gürcan ASLAN1
1Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi, 2. Plastik ve Rekonstrüktif Cerrahi Kliniği, Ankara
2Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Ankara
OBJECTIVES
The aim of this study is to evaluate various surgical techniques used for the coverage of skin defects resulting from neural defect repair in myelomeningocele cases.

STUDY DESIGN
The study included 11 patients (5 girls, 6 boys, age range 15 to 90 days) who underwent surgical reconstruction with various flap techniques for large myelomeningocele defects. The localization of the lesions was thoracolumbar in three patients and lumbosacral in eight patients. The mean follow-up period was nine months (range 3 to 12 months).

RESULTS
The skin defects were repaired with a bilateral rotation flap in one patient, bilateral latissimus dorsi myocutaneous flap in two patients, bilateral reverse-split latissimus dorsi V- Y myocutaneous advancement flap in three patients, bilateral W-rhomboid flap in three patients, and by primary closure and a transposition flap in one patient. Primary closure was performed in one patient. In particular, myocutaneous flaps were preferred in all cases with kyphosis and a large skin defect. No complications were encountered.

CONCLUSION
The fırst step in myelomeningocele treatment is surgical intervention for the neural defect. The primary aim of the plastic surgeon is to cover the ensuing defect and the neural structures with a well-vascularized and durable tissue. Anahtar Kelimeler : Infant, newbom; lumbar vertebrae; lumbosacral region; meningomyelocele; surgery, plastic; surgical flaps; suture techniques