Reversed turnover latissimus dorsi muscle flap for closure of large myelomeningocele defects

Abstract

Soft-tissue coverage of large myelomeningocele defects is a major surgical challenge that requires close co-operation between neurosurgeons and plastic surgeons to achieve adequate, durable and tension-free coverage of the neural tube. This study was conducted in Zagazig university hospitals on 11 infants, born with large thoracolumbar myelomeningocele defects, presented from June 2004 to February 2007. These defects were reconstructed by using reversed turnover latissimus dorsi muscle flap covered by split-thickness skin graft. The infants were between the ages of 2 and 5 days at the time of surgery and were followed up for 6-12 months postoperatively. All patients tolerated the procedure without major complications. This method provides a tension-free, stable and durable soft-tissue coverage with well-vascularised tissue over the dural repair.