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Autologous amnion graft for repair of myelomeningocele: technical note and clinical implication
Mitsuhiro Hasegawa1, Hironori Fujisawa, Yutaka Hayashi
1Department of Neurosurgery, Division of Neuroscience, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. hasegawa@ns.m.kanazawa-u.ac.jp
Objective And Importance:
Amniotic membrane can be used as autologous reconstruction graft material when aseptically obtained. We introduce here a novel repair technique using autologous amnion graft, and report a case presentation of myelomeningocele successfully treated with this graft material.
Technique:
Amniotic membrane, which was composed of amnion and chorion, was aseptically harvested at cesarean section. Removing chorionic tissue, amnion containing monolayer of amniotic epithelial cells and underlining fibrous tissue was isolated. After the procedure of reconstruction of neural and meningeal elements, the membrane was placed as onlay autograft over the reconstructed neural structure followed by suture of undermined skin flap without any myocutaneous flap transfer technique or fascial transposition from paraspinal muscles.
Results:
The postoperative healing process of the wound was excellent.
Conclusion:
Autograft of amniotic tissue has no risks of rejection, foreign body reaction, or transmission of slow virus infection to reconstruct the lesion of newborn patient. Amnion autograft would be a biologic rationale to promote wound healing, being applied as a part of a variety of pediatric neurosurgical procedure.