Luce E A, Walsh J
Plast Reconstr Surg. 1985 Mar;75(3):389-93. doi: 10.1097/00006534-198503000-00015.
Our experience with 74 neonates with myelomeningocoele is reported. Management in the first phase of the study period consisted of primary closure in 37 patients by wide undermining and skin advancement, marked by a high wound-complication rate. Latissimus dorsi muscle closure, either "reverse" or advanced, was performed in a transitional phase in 5 patients, characterized by increased operative time and blood loss. In the last portion of the study period, 32 patients were managed by immediate dural closure and skin grafts either simultaneously or on a delayed basis at 48 to 72 hours with a low incidence of graft loss, CSF leak, or sepsis. Back ulceration and follow-up in either the primary closure or the skin-grafted group has been infrequent.
我们报告了74例患有脊髓脊膜膨出症新生儿的治疗经验。在研究期的第一阶段，37例患者采用广泛潜行分离和皮肤推进进行一期缝合，其特点是伤口并发症发生率高。在过渡阶段，5例患者采用“反向”或推进式背阔肌肌瓣缝合，其特点是手术时间延长和失血增加。在研究期的最后阶段，32例患者采用立即硬脑膜缝合和皮肤移植，同时或在48至72小时延迟进行，植皮丢失、脑脊液漏或败血症的发生率较低。一期缝合组或植皮组的背部溃疡及随访情况均不常见。
