Role of perforator flaps in meningomyelocele defect repair

Abstract

Background: With an incidence of 1–2 in 1000 live births, meningocele is a relatively frequent birth defect. The lumbosacral region is affected in threequarters of the cases. It may lead to urinary and fecal incontinence, as well as plegia or paresis in the lower extremity. A large number of techniques have been described for meningomyelocele defect repair. Aims and Objectives: We reviewed perforator flaps used in meningomyelocele defect repair on patients admitted to our clinic and compared it with literature. Materials and Methods: This study included 12 newborns operated between January 2012 and February 2019. Results: The meningomyelocele was located in the thoracolumbar area in five patients and the lumbosacral area in 7 patients. The patients weights were 1830–3800 g. The most commonly used flap was the superior gluteal artery flap (n:5). Other flaps that were commoly used are the dorsal intercostal artery perforator (DIAP) and the lumbar artery perforator flaps. In two patients CSF leak was seen and one patient distal necrosis was seen. Conclusion: Perforator flaps can be used safely with a relatively low complication rate in meningomyelocele defect repair. It seems to be an alternative for safe, rapid, less bleeding, and easy surgery resulting in a solution for the closure of large meningomyelocele defects.

Keywords

• lumbar tissue defect
• meningomyelocele
• perforator flap