An urgent closure of myelomeningocele defects was carried out in 82 newborns using latissimus and/or trapezius musculocutaneous advancement flaps. A three-layer closure of skin, muscle, and fascia was achieved in a single stage without a flank skin graft. All of the wounds healed within a two-week period and no late breakdown of the wound occurred during the eight-year period of study. The urgent closure maximized the neurological salvage and facilitated early cerebrospinal fluid shunting by preventing both infection and neural desiccation. This report represents the largest number of sequentially treated myelomeningocele defects without a major wound healing problem or death. The advancement musculocutaneous flap closure is safe, simple, and effective and is recommended as the preferred method for closure of the myelomeningocele defect.
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A Large Thoracolumbosacral Meningomyelocele From Northern Tanzania: A Case Report.
Case Rep Surg
January 2025
Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi PO Box 3010, Tanzania.
Meningomyelocele and meningocele are types of neural tube defects, which are congenital abnormalities of the spine and spinal cord. These conditions are frequently encountered by pediatric neurosurgeons worldwide and represent a significant public health concern due to their association with a range of collateral conditions, other malformations, and increased morbidity. While many cases can be identified during prenatal ultrasound screenings, this is often challenging in resource-limited settings with poor health-seeking behaviors.
View Article and Find Full Text PDFNeurodevelopmental Outcomes after Fetoscopic Myelomeningocele Repair.
J Pediatr
January 2025
Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, United States. Electronic address:
Objectives: To report the neurodevelopmental outcomes after a fetoscopic myelomeningocele (MMC) repair and to compare them with children who had an open-hysterotomy repair or a postnatal repair.
Study Design: 132 infants were included (prenatal repair: 93 [69 fetoscopic and 24 open-hysterotomy]; postnatal repair: 39). Neurodevelopmental outcomes at or beyond 18 months were evaluated by a developmental pediatrician using the Capute scales (Clinical Adaptive Test [CAT]/ Clinical Linguistic & Auditory Milestone Scale [CLAMS]) and/or during parental interview using Developmental Profile 3 (DP-3) test.
Mode of Delivery and Subsequent Motor Function in Children With Myelomeningocele Without In Utero Repair.
Obstet Gynecol
January 2025
Departments of Obstetrics and Gynecology and Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin; University of Pittsburgh Medical Center, Magee-Women's Hospital, and the Children's Hospital of Pittsburgh, Pittsburgh, and the Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; the Department of Neurosurgery, Duke University Medical Center, Duke Children's Hospital, Durham, North Carolina; the University of Michigan, Ann Arbor, Michigan; the Department of Surgery (and Maternal Fetal Care Center), Boston Children's Hospital, Boston, Massachusetts; Children's Minnesota, St. Paul and Minneapolis, Minnesota; the Johns Hopkins Center for Fetal Therapy, Baltimore, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee; Wexner Medical Center, The Ohio State University, Columbus, Ohio; Stanford University School of Medicine, Stanford, and UC Davis Fetal Care and Treatment Center, Sacramento, California; St. Louis University, St. Louis, Missouri; University of Rochester Medical Center, Rochester, New York; and UTHealth Houston Fetal Center, University of Texas McGovern Medical School at Houston, Houston, Texas.
Objective: To assess the association between mode of delivery and 2-year motor function in children with prenatal diagnosis of myelomeningocele.
Methods: A multisite retrospective cohort study of children with myelomeningocele across 14 NAFTNet (North American Fetal Therapy Network) centers born between 2007 and 2020 who had a physical examination available at 2 years of life. Exclusion criteria were in utero myelomeningocele repair, postnatal myelomeningocele diagnosis, missing data on fetal presentation at delivery, and contraindications to labor.
Bayesian polygenic risk estimation approach to nuclear families with discordant sib-pairs for myelomeningocele.
PLoS One
January 2025
Department of Genetics, National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ), Mexico City, Mexico.
Myelomeningocele (MMC) is the most severe and disabling form of spina bifida with chronic health multisystem complications and social and economic family and health systems burden. In the present study, we aimed to investigate the genetic risk estimate for MMC in a cohort of 203 Mexican nuclear families with discordant siblings for the defect. Utilizing a custom Illumina array, we analyzed 656 single nucleotide polymorphisms (SNPs) of 395 candidate genes to identify a polygenic risk profile for MMC.
View Article and Find Full Text PDFConcurrent myelomeningocele and sagittal craniosynostosis: illustrative case.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina.
Background: Myelomeningocele and sagittal craniosynostosis are 2 neurosurgical pathologies with complications such as increased intracranial pressure (ICP) and hydrocephalus. While the 2 defects commonly occur independently, their simultaneous occurrence is exceptionally rare.
Observations: The authors report the case of a newborn male diagnosed with a simultaneous myelomeningocele and sagittal craniosynostosis.
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