Meningomyelocele Reconstruction: Comparison of Repair Methods via Systematic Review

Area of Science:

• Plastic Surgery
• Pediatric Surgery
• Reconstructive Surgery

Background:

• Meningomyelocele (MMC) is a complex congenital condition requiring surgical repair.
• Effective reconstruction of MMC defects is crucial for patient outcomes.
• Various surgical techniques exist for MMC defect closure.

Purpose of the Study:

• To systematically review and appraise different reconstruction methods for meningomyelocele (MMC) defects.
• To identify the most effective techniques for minimizing complications.
• To guide surgical decision-making in MMC repair.

Main Methods:

• Systematic literature review of 567 articles, with 29 included for qualitative synthesis.
• Categorization of reconstruction methods: primary closure, fascial flaps, random pattern flaps, VY advancement flaps, perforator flaps, and myocutaneous flaps.
• Analysis of major wound complications (MWC) rates based on reconstruction technique and defect location.

Main Results:

• Myocutaneous and random pattern flaps were associated with the lowest rates of major wound complications (MWC).
• The lumbrosacral/sacral region accounted for 87.5% of MWC.
• In the lumbrosacral/sacral region, random pattern and perforator flaps showed the lowest MWC rates (4.5% and 8.1%, respectively).

Conclusions:

• Plastic surgery consultation is highly recommended for MMC defects in the lumbosacral/sacral region.
• Perforator flaps represent an excellent reconstructive option for these specific defects.
• Optimizing surgical technique can significantly reduce MWC in MMC repair.