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Updated: Oct 16, 2025

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Our Clinical Algorithmic Approach for Meningomyelocele Defects Reconstruction with Fasciocutaneous Flaps.

Mehmet Fatih Algan1, Cemal Firat, Kagan Bekircan

  • 1Malatya Turgut Ozal University, Malatya Education and Research Hospital, Department of Plastic Surgery, Malatya, Turkey.

Turkish Neurosurgery
|October 19, 2021
PubMed
Summary

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Fasciocutaneous flaps are effective for meningomyelocele defect reconstruction, offering reliable circulation and low complication rates. A new algorithm aids in selecting the appropriate flap based on defect size for optimal surgical outcomes.

Area of Science:

  • Plastic Surgery
  • Pediatric Surgery
  • Reconstructive Surgery

Background:

  • Meningomyelocele defects present significant reconstructive challenges.
  • Fasciocutaneous flaps are a reconstructive option, but selection criteria require refinement.

Purpose of the Study:

  • To evaluate the efficacy of various fasciocutaneous flaps for meningomyelocele defect reconstruction.
  • To propose a practical algorithm for selecting the optimal fasciocutaneous flap based on defect size.

Main Methods:

  • Retrospective analysis of 45 patients with meningomyelocele undergoing reconstruction with fasciocutaneous flaps.
  • Analysis of defect dimensions using digital imaging software.
  • Evaluation of flap types including Limberg, bilateral Limberg, bilateral bipedicled advancement, bilobed, and reading man flaps.

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Main Results:

  • A low complication rate was observed, with wound dehiscence and partial necrosis in 8 patients, all managed conservatively.
  • The mean defect size was 36 cm², with variations across flap types.
  • An algorithm was developed correlating defect size (<25 cm², 25-35 cm², >35 cm²) with specific flap recommendations.

Conclusions:

  • Fasciocutaneous flaps are a reliable choice for meningomyelocele reconstruction due to ease of planning, elevation, and robust circulation.
  • The proposed algorithm simplifies flap selection by utilizing objective defect area measurements.
  • This approach aims to improve surgical planning and patient outcomes in meningomyelocele repair.