Related Experiment Video
Updated: Jun 28, 2025
Author Spotlight: Non-Contact Measurement of Tissue Mechanics in Live Chick Embryos Using Brillouin Microscopy
Published on: November 10, 2023
Flap Closure in Neonatal Neural Tube Defects: Challenges in Flap Design and Lessons Learnt
Nitin Sharma1, Shipra Sharma2, Mini Sharma3
1Department of Paediatric Surgery, DKSPGI and Research Center, Raipur, Chhattisgarh, India.
Background:
Management of neural tube defects (NTDs) is challenging and the outcome is demanding.
Aims:
To analyze the outcomes in operated cases of NTDs closed using various types of flaps.
Materials And Methods:
The data between June 2017 and May 2023 were analyzed. The mode of presentation, timing of intervention, type of flap, neurological status after closure, status of the wound, presence of hydrocephalous, flap blackening, flap necrosis, features of sepsis, and the outcome were recorded and analyzed. Covered NTD; closure done using primary closure or 'Z' Plasty (everywhere); incomplete data; lost to follow-up; and not giving consent were excluded from the study.
Results:
Out of 92 cases, 35 were operated using the rhomboid flap, 33 using dufourmentel modification of limberg flap, and 24 using keystone island flap. The mean age at presentation was 4 days (range: 0-28 days). The mean duration of surgery after presentation was 2 days (range: 1-3 days). Mean operating time was 1.15 h (range: 0.45-3.15 h). A ventriculoperitoneal shunt was required in 62 cases at various stages. The preoperative and the postoperative power were nearly the same in all. Wound infection was seen in 2, 3, and 1 cases in each group. Blackening of the flap was seen in 3, 2, and 1 cases in three groups. Cerebrospinal fluid (CSF) leak was seen in 2, 2, and 0 cases. Wound dehiscence was present in one case in each group and sepsis was present in 2, 3, and 2, respectively.
Conclusion:
The management of open NTD requires adequate planning. CSF shunting and flap closure are often required.
