Arch Plast Surg.  2021 May;48(3):261-268. 10.5999/aps.2020.01326.

Closure of meningomyelocele defects using various types of keystone-design perforator island flaps

Affiliations
  • 1Division of Plastic, Reconstructive, and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia

Abstract

Background
Various methods have been described to close large meningomyelocele defects, but no technique has been proven superior to others. This study presents cases of meningomyelocele defect closure with a keystone-design perforator island flap.
Methods
A retrospective study was performed on 14 patients with meningomyelocele defects closed using various types of keystone flaps.
Results
The median age of the patients at surgery was 10.5 days (range, 1–369 days) and the average defect size was 22.5 cm2 (range, 7.1–55.0 cm2). The average operative time for defect closure was 89.6 minutes (range, 45–120 minutes). Type IV bilateral keystone flaps were used for four defects, type IV unilateral flaps for six defects, type IIA flaps for two defects, and type III flaps for two defects.
Conclusions
All the defects healed completely with no major complications. The keystone-design perforator island flap is a reliable, easy, and fast technique to close large meningomyelocele defects.

Keyword

Surgery, plastic / Meningomyelocele / Perforator flaps / Island flaps / Surgical flaps
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