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脊髓脊膜膨出修复术后的筋膜皮瓣重建:技术与结果

Fasciocutaneous Flap Reconstruction after Repair of Meningomyelocele: Technique and Outcome.

作者信息

Jabaiti Samir, Al-Zaben Khaled R, Saleh Qussay, Abou Alrob Mohammad, Al-Shudifat Abdul Rahman

出版信息

Pediatr Neurosurg. 2015;50(6):344-9. doi: 10.1159/000439283. Epub 2015 Oct 13.

Abstract

AIMS

The objectives of this study are to describe our technique in meningomyelocele (MMC) repair, analyzing the results and complications, as well as to study the effect of delay in operation on the complication rate.

PATIENTS AND METHODS

Between March 1997 and October 2012, 48 patients with MMC were treated at Jordan University Hospital by a combined neurosurgical and plastic surgical team. Patients underwent neurosurgical repair of the neural elements and soft tissue reconstruction using local fasciocutaneous flaps. The patients were further divided into two subgroups (local or referrals from other hospitals).

RESULTS

Of all patients, 8 (16.6%) had postoperative complications. When the complication rate was compared between the two groups, in the first group, who had early repair, only 2 out of 19 patients had complications (10.5%), while in the second group, with delayed operation, 6 out of 29 patients developed complications (20.7%). The follow-up of all patients showed that the soft tissue cover maintained good durability with no skin breakdown.

CONCLUSION

We recommend early MMC repair using this rather simple method to provide a reliable soft tissue coverage. A combined approach by a neurosurgical and plastic surgical team in the management of this challenging neonatal emergency is appreciated.

摘要

目的

本研究的目的是描述我们在脊髓脊膜膨出(MMC)修复中的技术,分析结果和并发症,以及研究手术延迟对并发症发生率的影响。

患者与方法

1997年3月至2012年10月期间,约旦大学医院的神经外科和整形外科联合团队对48例MMC患者进行了治疗。患者接受了神经外科对神经组织的修复以及使用局部筋膜皮瓣进行软组织重建。患者进一步分为两个亚组(本地患者或来自其他医院的转诊患者)。

结果

所有患者中,8例(16.6%)出现术后并发症。比较两组的并发症发生率时,第一组为早期修复,19例患者中只有2例出现并发症(10.5%),而第二组手术延迟,29例患者中有6例出现并发症(20.7%)。对所有患者的随访显示,软组织覆盖保持了良好的耐用性,没有皮肤破损。

结论

我们建议采用这种相当简单的方法早期进行MMC修复,以提供可靠的软组织覆盖。神经外科和整形外科联合团队在处理这种具有挑战性的新生儿急症方面的综合方法值得赞赏。

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