The international scientific journal Child’s Nervous System has included in its January 2019 issue an article of mine on myelomeningocele (MMC).
The article is entitled “Long-term follow-up of myelomeningocele defect closure with perforator helix flaps of the dorsal intercostal artery” and reports the work carried out by Dr. Eva López, Dr. Pablo Miranda and myself at the Pediatric Plastic Surgery Unit and the Pediatric Neurosurgery Unit of the Hospital La Fe of Valencia.
About myelomeningocele
As I explain in the article, closure of the skin defect in myelomeningocele repair determines the quality of the surgical outcome. In large myelomeningoceles, direct closure or weakening of the skin may not be possible. In these cases, the skin defect must be closed by the use of flaps to provide a tension-free and successful closure.
In this procedure, after neurosurgical repair and closure of the placode, the defect is surgically converted into an ovoid shape. Then, this defect is closed by transposition of two flaps of the perforator helix of the dorsal intercostal artery. The size of the defect was> 5 cm in diameter. The location of the lesion was lumbosacral.
Successful closure of a tension-free stage was obtained without necrosis. Healing was uneventful without complications and coverage remained stable for 9 years as the child grew.
In conclusion, the dorsal intercostal artery perforator helix flap allows the surgeon to achieve tension-free defect closure of significantly large myelomeningocele defects. This type of closure provides durable coverage and soft tissue filling over neural tissues that persist as the child grows. The dorsal intercostal artery perforator helix flap appears to be a useful closure of large myelomeningocele defects.
Child’s Nervous System is the official journal of the International Society of Pediatric Neurosurgery.
You can consult the abstract of the article in this web page:
https://doi.org/10.1007/s00381-018-04030-x
