Long-term follow-up of Keystone Perforator Island Flap reconstructed Myelomeningocele Defects

Myelomeningocele (a type of spina bifida) is the most common congenital condition causing lifelong physical disability and requiring multi-system surgical procedures. Therefore it is paramount to reconstruct them with a stable and robust method that heals with minimal wound issues and produces maximum durability. We published a case series on myelomeningocele defects reconstruction with keystone perforator island flap in the Annals of Plastic Surgery in 2016.1 We would like to report our long-term follow-up of 14 years on our case series assessing their scars with POSAS 3.0. We also assessed their quality of life using the QUALAS tool for teenagers. While there are multiple reconstructive options for the closure of myelomeningocele defects, we believe that the keystone perforator island flap technique is reliable and safe as it incorporates en bloc movement of a large flap of well-vascularised skin, cutis and muscular fascia to close large defects on newborns lumbar-sacral regions and with stable scars.2-7