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Myelomeningocele closure by unilateral lumbar artery perforator flap: Experience with thirty-eight patients
1Plastic and Reconstructive Surgery, Nevsehir Public Hospital, Nevsehir, Turkey.
Background:
Repair of large soft tissue defects in meningomyelocele is difficult and its morbidity is high. By applying unilateral lumbar artery perforator transposition flap for closing these defects, we aimed to investigate effects on the repair procedure, duration of surgery and recovery period, with the rates of bleeding and morbidity.
Patients And Methods:
Our report was conducted in 38 patients between the years 2013 and 2017. All soft tissue defects were repaired with unilateral lumbar artery perforator flap (LAPF) in meningomyelocele. Fourteen patients were female and 24 patients were male. The youngest patient was a 5.5 month premature female baby and weighing 570 g. The oldest was weighing 3,700 g and at 1.5 months old.
Results:
Mean flap size was 32 ± 29.4 cm2 (ranged: 4 × 3-8 × 7 cm2 ). The mean rotation angle was 126.7° (ranged: 90°-170°). Flap positions were separated as 9 (23%) thoracodorsal and 29 (77%) lumbosacral. None of the patients had flap necrosis, infection, or hematoma. The operation took 23 ± 5.3 minutes on average and bleeding was minimal as 16 cc. All patients were discharged within around 9 ± 2 days. The follow-up period of the patient ranged from 4 to 21 months. Flap survival was at the rate of 100%. There was no flap or postoperative complications. Final outcome for all patients were assessed as complete healing. All patients recovered fast with minimal blood lose, and satisfied the outcomes.
Conclusions:
As a result, unilateral lumbar perforator flap can be performed successfully in every center. This report suggests using LAPF for reconstruction of meningomyelocele by surgeons as a safe and reliable option, allowing surgeons strong results.
Insights
Unilateral lumbar artery perforator flaps (LAPF) offer a safe and effective solution for meningomyelocele soft tissue defects, demonstrating 100% flap survival and minimal complications. This method ensures successful repair, fast recovery, and high patient satisfaction.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Reconstructive Surgery
Background:
- Repairing large soft tissue defects in meningomyelocele (spina bifida) presents significant surgical challenges with high morbidity rates.
- Traditional methods for closing these defects often lead to complications, necessitating innovative reconstructive techniques.
Purpose of the Study:
- To evaluate the efficacy and safety of using unilateral lumbar artery perforator flaps (LAPF) for reconstructing soft tissue defects in patients with meningomyelocele.
- To assess the impact of LAPF on surgical procedure, operation duration, recovery period, and complication rates.
Main Methods:
- A cohort of 38 patients (14 female, 24 male) with meningomyelocele underwent soft tissue defect repair using unilateral lumbar artery perforator flaps (LAPF) between 2013 and 2017.
- Patient demographics included a premature infant weighing 570g and an older infant weighing 3,700g at 1.5 months old.
Main Results:
- All 38 patients achieved 100% flap survival with no instances of flap necrosis, infection, or hematoma.
- The average operation time was 23 minutes with minimal blood loss (16 cc), and patients were discharged within 9 days.
- Postoperative follow-up (4-21 months) revealed complete healing and no flap-related or surgical complications.
Conclusions:
- Unilateral lumbar artery perforator flap (LAPF) reconstruction is a safe, reliable, and highly successful option for meningomyelocele defects.
- LAPF can be performed successfully in various surgical centers, offering strong outcomes and patient satisfaction.
- This technique facilitates rapid recovery with minimal complications, making it a valuable reconstructive choice.
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