de Weerd Louis, Sjåvik Kristin, Pedersen Lars Kjelsberg, Weum Sven, Hennig Rune Otto
Department of Plastic and Reconstructive Surgery, University Hospital of North Norway, Tromsø, Norway.
Medical Imaging Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
Plast Reconstr Surg Glob Open. 2020 Jan 20;8(1):e2539. doi: 10.1097/GOX.0000000000002539. eCollection 2020 Jan.
This article describes the triple use of autologous amnion graft as a new procedure in the treatment of myelomeningocele and in myelomeningocele with split cord malformation. The first amnion graft was used as a physical and mechanical barrier to protect the myelomeningocele (MMC) from desiccation and mechanical stress directly after birth. A second graft was used as a dura substitute to close the cerebrospinal fluid compartment. Autologous amnion seems to be the ideal dural graft for closure of an MMC and for an MMC with split cord malformation. A tension-free and watertight closure was obtained. With the epithelium side placed to the spinal cord and due to its beneficial effect on scar formation, the risk for tethering cord syndrome is reduced when using autologous amnion as a dural graft. The regenerative properties of autologous amnion may contribute to repair neural damage. Finally, a third amnion graft was placed beneath the perforator flap used to close the skin defect to provide a watertight barrier and to stimulate flap survival.
本文介绍了自体羊膜移植的三重应用，这是一种治疗脊髓脊膜膨出以及合并脊髓纵裂畸形的脊髓脊膜膨出的新方法。首次羊膜移植用作物理和机械屏障，在出生后直接保护脊髓脊膜膨出（MMC）免受干燥和机械应力影响。第二次移植用作硬脑膜替代物以封闭脑脊液腔。自体羊膜似乎是用于闭合脊髓脊膜膨出以及合并脊髓纵裂畸形的脊髓脊膜膨出的理想硬脑膜移植材料。实现了无张力且防水的闭合。将上皮侧置于脊髓上，并且由于其对瘢痕形成的有益作用，当使用自体羊膜作为硬脑膜移植材料时，脊髓拴系综合征的风险降低。自体羊膜的再生特性可能有助于修复神经损伤。最后，将第三层羊膜移植置于用于闭合皮肤缺损的穿支皮瓣下方，以提供防水屏障并促进皮瓣存活。
