Ucak Murat
Plastic and Reconstructive Surgery, Nevsehir Public Hospital, Nevsehir, Turkey.
Microsurgery. 2018 Oct;38(7):752-757. doi: 10.1002/micr.30348. Epub 2018 Jun 28.
Repair of large soft tissue defects in meningomyelocele is difficult and its morbidity is high. By applying unilateral lumbar artery perforator transposition flap for closing these defects, we aimed to investigate effects on the repair procedure, duration of surgery and recovery period, with the rates of bleeding and morbidity.
Our report was conducted in 38 patients between the years 2013 and 2017. All soft tissue defects were repaired with unilateral lumbar artery perforator flap (LAPF) in meningomyelocele. Fourteen patients were female and 24 patients were male. The youngest patient was a 5.5 month premature female baby and weighing 570 g. The oldest was weighing 3,700 g and at 1.5 months old.
Mean flap size was 32 ± 29.4 cm (ranged: 4 × 3-8 × 7 cm ). The mean rotation angle was 126.7° (ranged: 90°-170°). Flap positions were separated as 9 (23%) thoracodorsal and 29 (77%) lumbosacral. None of the patients had flap necrosis, infection, or hematoma. The operation took 23 ± 5.3 minutes on average and bleeding was minimal as 16 cc. All patients were discharged within around 9 ± 2 days. The follow-up period of the patient ranged from 4 to 21 months. Flap survival was at the rate of 100%. There was no flap or postoperative complications. Final outcome for all patients were assessed as complete healing. All patients recovered fast with minimal blood lose, and satisfied the outcomes.
As a result, unilateral lumbar perforator flap can be performed successfully in every center. This report suggests using LAPF for reconstruction of meningomyelocele by surgeons as a safe and reliable option, allowing surgeons strong results.
脊髓脊膜膨出症中大型软组织缺损的修复难度大且发病率高。通过应用单侧腰动脉穿支移位皮瓣来闭合这些缺损，我们旨在研究其对修复过程、手术时长和恢复期的影响，以及出血率和发病率。
我们的报告纳入了2013年至2017年间的38例患者。所有脊髓脊膜膨出症的软组织缺损均采用单侧腰动脉穿支皮瓣（LAPF）进行修复。女性患者14例，男性患者24例。最年轻的患者是一名5.5个月大的早产女婴，体重570克。年龄最大的患者体重3700克，1.5个月大。
皮瓣平均大小为32±29.4平方厘米（范围：4×3 - 8×7平方厘米）。平均旋转角度为126.7°（范围：90° - 170°）。皮瓣位置分为胸背侧9例（23%）和腰骶部29例（77%）。所有患者均未出现皮瓣坏死、感染或血肿。手术平均耗时23±5.3分钟，出血量极少，为16毫升。所有患者均在约9±2天内出院。患者的随访期为4至21个月。皮瓣存活率为100%。未出现皮瓣或术后并发症。所有患者的最终结局评估为完全愈合。所有患者恢复迅速，失血极少，对结局满意。
因此，单侧腰穿支皮瓣在每个中心都能成功实施。本报告表明，外科医生可将LAPF用于脊髓脊膜膨出症的重建，这是一种安全可靠的选择，能让外科医生取得良好的效果。
