Experience with various reconstructive techniques for meningomyelocele defect closure in India

Area of Science:

• Pediatric Surgery
• Neurosurgery
• Plastic Surgery

Background:

• Spina bifida incidence is 1-2 per 1000 population.
• Meningomyelocele (MMC) prevalence is approximately 0.8-1.0 per 1000 live births globally.
• This study evaluates surgical outcomes for MMC defects.

Purpose of the Study:

• To analyze the outcomes of various surgical procedures for meningomyelocele (MMC) defect closure.
• To assess the effectiveness of different flap techniques in managing MMC defects.

Main Methods:

• Retrospective review of 22 patients with MMC defects treated between July 2016 and August 2018.
• Analysis of patient demographics, defect characteristics, surgical procedures, complications, and outcomes.
• Involvement of plastic surgery for defect closure.

Main Results:

• Local flap techniques, including Limberg flap (11 cases), primary/double rotation flaps (4 cases), triple rotation flap (1 case), and local transposition flaps (2 cases), were utilized.
• Complications were minimal, with only 3 cases experiencing local wound infection or dehiscence, all managed conservatively.
• Average closure time in India was approximately 70 days, with delays often linked to initial consultation at non-specialized departments.

Conclusions:

• Local flap options like Limberg flap, local transposition flap, and rotation flaps are effective for managing meningomyelocele (MMC) defects.
• Delayed presentation to specialized centers, often due to initial contact with other departments, contributes to longer closure times.