McCraw J B, Penix J O, Freeman B G, Vincent M P, Wirth F H
Ann Plast Surg. 1987 Feb;18(2):147-55. doi: 10.1097/00000637-198702000-00008.
An urgent closure of myelomeningocele defects was carried out in 82 newborns using latissimus and/or trapezius musculocutaneous advancement flaps. A three-layer closure of skin, muscle, and fascia was achieved in a single stage without a flank skin graft. All of the wounds healed within a two-week period and no late breakdown of the wound occurred during the eight-year period of study. The urgent closure maximized the neurological salvage and facilitated early cerebrospinal fluid shunting by preventing both infection and neural desiccation. This report represents the largest number of sequentially treated myelomeningocele defects without a major wound healing problem or death. The advancement musculocutaneous flap closure is safe, simple, and effective and is recommended as the preferred method for closure of the myelomeningocele defect.
对82例新生儿采用背阔肌和/或斜方肌肌皮推进皮瓣紧急闭合脊髓脊膜膨出缺损。在一期手术中实现了皮肤、肌肉和筋膜的三层闭合，无需侧腹壁皮肤移植。所有伤口均在两周内愈合，在为期八年的研究期间未发生伤口后期裂开。紧急闭合最大限度地挽救了神经功能，并通过预防感染和神经干燥促进了早期脑脊液分流。本报告是连续治疗脊髓脊膜膨出缺损数量最多的报告，且无重大伤口愈合问题或死亡。推进肌皮瓣闭合安全、简单且有效，推荐作为闭合脊髓脊膜膨出缺损的首选方法。
