Banda Chihena H, Narushima Mitsunaga, Ishiura Ryohei, Fujita Minami, Furuya Megumi
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan.
Plast Reconstr Surg Glob Open. 2018 Dec 14;6(12):e2012. doi: 10.1097/GOX.0000000000002012. eCollection 2018 Dec.
Major wound necrosis is an uncommon yet critical complication of meningomyelocele surgical repair with few reports available. Management is demanding and often requires further reconstructive surgery. We report a case of a neonate who developed extensive wound necrosis with dehiscence following primary repair of myelomeningocele. The large defect was reconstructed using transposition fasciocutaneous flaps and negative pressure wound therapy applied over the flap donor sites resulting in wound closure, alleviating the need for further surgery. We report this case to highlight the importance of local flap design in reconstruction of the complex wounds seen following meningomyelocele repair wound necrosis. Additionally, we report the unique utilization of negative pressure wound therapy in the management of myelomeningocele.
大面积伤口坏死是脊髓脊膜膨出手术修复中一种罕见但严重的并发症,相关报道较少。其处理颇具挑战性,通常需要进一步的重建手术。我们报告一例新生儿,在脊髓脊膜膨出一期修复后出现广泛伤口坏死并裂开。使用转位筋膜皮瓣修复大的缺损,并在皮瓣供区应用负压伤口治疗,最终实现伤口闭合,避免了进一步手术的需要。我们报告此病例以强调局部皮瓣设计在脊髓脊膜膨出修复伤口坏死所致复杂伤口重建中的重要性。此外,我们还报告了负压伤口治疗在脊髓脊膜膨出处理中的独特应用。