Reconstructive management of an extensive myelomeningocele defect using allogeneic fascia lata as temporary...

Extensive myelomeningocele defects may be difficult to reconstruct when tension-free primary skin closure cannot be achieved, and an appropriate local flap is not available. In such cases, various biological materials and dermal substitutes have been used. Allogeneic fascia lata is a mechanically robust tissue with established use in reconstructive surgery, but its use as temporary superficial biological coverage for extensive myelomeningocele defects has not been specifically described.

We report a term male newborn weighing 3.5 kg with a 16 × 10 cm thoracolumbosacral myelomeningocele and insufficient surrounding skin to achieve tension-free primary closure. After neural repair and watertight dural closure, the defect was covered with allogeneic fascia lata obtained from the Tissue Bank of Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" and used as temporary biological coverage. During follow-up, progressive granulation tissue formation and centripetal epithelialization from the skin margins were observed, with complete epithelial coverage achieved at four months. At one-year follow-up, the reconstructed area remained stable, with no local infection or need for additional reconstructive procedures.

Banked allogeneic fascia lata may be a salvage option for temporary biological coverage of extensive myelomeningocele defects when conventional reconstructive options are not feasible. Potential advantages include mechanical strength, avoidance of donor-site morbidity, and immediate availability in centers with institutional tissue banks, with potential logistical and economic benefits compared with commercially manufactured substitutes. These findings are based on a single case and do not establish comparative efficacy, safety, or reproducibility of the technique.