Campobasso Paolo, Pesce Ciro, Costa Lorenzo, Cimaglia Maria Luisa
Division of Pediatric Surgery, San Bortolo Hospital, Viale Rodolfi (I), 36100, Vicenza, Italy.
Pediatr Surg Int. 2004 Feb;20(2):144-7. doi: 10.1007/s00383-003-1056-8. Epub 2004 Feb 10.
Closure of the skin defect in myelomeningocele repair is an essential step that determines the quality of the surgical result. In large myelomeningoceles, however, adequate skin coverage may not be accomplished by direct closure or skin undermining. In such cases, the skin defect is best repaired using flaps. To evaluate whether the Limberg skin flap is effective for the repair of large round or oval lumbosacral myelomeningoceles, we studied the records of 25 children. Surgical repair was carried out within 24-36 hours of birth in all 25 patients, with the defect size ranging from 36-72 cm(2). Durable, stable soft tissue coverage of the defect was obtained in 23 of 25 patients, with a postoperative follow-up of at least 2 years. Reoperation became necessary in the remaining two patients, but flap necrosis occurred in only one. We suggest that Limberg flap repair may have some advantages in patients with large round or oval lumbosacral myelomeningoceles, including minimal invasivity, short hospitalization, and improved cosmetic results.
脊髓脊膜膨出修补术中皮肤缺损的闭合是决定手术效果质量的关键步骤。然而，对于大型脊髓脊膜膨出，直接缝合或皮下潜行分离可能无法实现足够的皮肤覆盖。在这种情况下，使用皮瓣修复皮肤缺损效果最佳。为评估Limberg皮瓣修复大型圆形或椭圆形腰骶部脊髓脊膜膨出是否有效，我们研究了25例患儿的病历。所有25例患者均在出生后24 - 36小时内进行手术修复，缺损面积为36 - 72平方厘米。25例患者中有23例获得了持久、稳定的缺损软组织覆盖，术后随访至少2年。其余2例患者需要再次手术，但仅1例发生皮瓣坏死。我们认为，Limberg皮瓣修复对于大型圆形或椭圆形腰骶部脊髓脊膜膨出患者可能具有一些优势，包括微创性、住院时间短和美容效果改善。
