Muhammad Hamid Ali, Bilal Fazal Shaikh, Mahesh Kumar, Adnan Maqsood Choudhry.
Outcome of surgical reconstruction of myelomeningocele defects – a study of 25 patients.
Med Channel Jan ;16(2):328-30.

OBJECTIVE: To evaluate the outcome of various reconstructive procedures performed for reconstruction of myelomeningocele defects. METHODOLOGY: This prospective descriptive study was conducted at Departments of Neurosurgery and Plastic & Reconstructive Surgery, Liaquat University Hospital, Jamshoro between June 2008 and May 2009. A total of 25 newborns admitted with myelomeningocele during the study period and repaired with various local flaps and skin grafting were included in this study. RESULTS: Out of Twenty five patients, 12 (48%) were males and 13 (52%) were females, age ranged from 1-48 months. Fifteen patients (60%) had defect in thoracolumbar region; ten patients (40%) had defects in lumbosacral region. ventriculoperitoneal shunts for hydrocephalus was placed in 8 patients (32%). Primary closure of defect was performed in 4 patients (16%), 3 patients (12%) were treated with rhomboid flap, Limberg flap was used to cover defects of 2 patients (8%), Lumber flap was used in 3 patients (12%), hatchet flap was used to close the defect of one patient (4%), double reverse flap was used to cover the defect in 5 patients (20%) and split thickness skin grafting was used in large defects of 7 patients (28%). CONCLUSION: Skin grafting is a excellent choice for treatment of wounds where the defect size is huge because there is diminutive morbidity associated with this method, local flaps are fine option for coverage but care should be taken to keep the suture line away from dural repair line to avoid dehiscence.

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