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4 - Delayed and nondelayed bilateral bipedicled fasciocutaneous flaps in large meningomyelocele defects: a preliminary results
Arzu Akcal, Semra Karsidag, Tahsin Görgülü, Kemal Uğurlu
Congenital fusion defects of the neural tube and the related structures are classified as spinal dysraphism. Meningomyelocele is a defect which is the most common form of spinal dysraphism and occurs at an approximate rate of 1 in 800-1000 live births. In untreated meningomyelocele patients, mortality rate is 65-70% within the first 6 months. Between 2006 January and 2009 January, 10 (6 female and 4 male) newborns with a meningomyelocele defect large enough that could not repaired primarily were included the our study. In the nondelayed group which were consisted of five newborns whose diameter of the meningomyelocele defect were less than 50%, flaps were advanced to the midline and the defect was closed. In delayed group, we preferred to take advantages of the delaying phenomenon in five newborns whose diameter of the meningomyelocele defect were more than 50% of the mid-axillary distance to prevent disrupting circulation of the flaps. After 1 week, defects were closed following repair of the neural defects and advancement of the delayed flaps. The monitoring of the patients during the delay period revealed no local and central nervous system infection symptoms. In conclusion, we propose that delayed bipedicle flaps as an alternative method for the repair of large meningomyelocele defects due to their simple and reliable nature which also causes less hemorrhage, and we use them on "ed patients in our clinic.
Keywords: Meningomyelocele, delaying phenomene, bilateral bipedicled fasciocutaneous
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