Lanigan M W
Department of Surgery, Mater Misericordiae Childrens Hospital, Brisbane, Australia.
Ann Plast Surg. 1993 Dec;31(6):514-21. doi: 10.1097/00000637-199312000-00007.
The birth of an infant with myelomeningocele provides a devastating experience for parents, a management dilemma for medical personnel, and an economic liability of immense proportions associated with the multiple disciplinary management program throughout the patient's life. Although undue delay in the onset of therapy is to be avoided, time can be taken for through assessment and appropriate discussion with the family without compromising the outcome. Once decisions are made to proceed with repair, early cover of the myelomeningocele defect is necessary to prevent progressive loss of neural tissue through exposure, desiccation, and sepsis. Many techniques of repair have been advocated. In principle, the ideal should be applicable to all sizes of defect, should be able to be executed in the neonatal age group with minimal morbidity, and should provide long-term, stable soft tissue cover without significant secondary scarring. A technique adhering to these principles is described and supported by results in a personal series of 84 patients during a 12-year period.
脊髓脊膜膨出婴儿的出生，给父母带来了毁灭性的经历，给医务人员带来了管理难题，并且在患者的整个生命过程中，与多学科管理计划相关联，构成了巨大的经济负担。尽管应避免治疗开始时的过度延迟，但可以在不影响治疗结果的情况下，花时间进行全面评估并与家庭进行适当讨论。一旦决定进行修复，尽早覆盖脊髓脊膜膨出缺损是必要的，以防止神经组织因暴露、干燥和感染而逐渐丧失。人们提倡了许多修复技术。原则上，理想的技术应适用于所有大小的缺损，应能够在新生儿年龄组中以最小的发病率实施，并且应提供长期、稳定的软组织覆盖，而不会产生明显的继发性瘢痕。本文描述了一种符合这些原则的技术，并以12年期间84例患者的个人系列结果作为支持。
