A new alternative flap in the closure of meningomyelocele defects: modified S flaps

Back defects may occur after several factors such as cancer, trauma and pressure sores. These conditions are more frequent in adult group, whereas the etiological factor in newborn infants is usually meningomyelocele defects. The aim of this study is to define more reliable and easily applicable surgical technique for the closure of meningomyelocele defects. This study included a total of 15 infants who underwent operation with the diagnosis of meningomyelocele and were treated with a modified S flap at our clinic between January 2016 and January 2017. During surgery, two flaps with a random pattern planned from the healthy skin on the right and left side of the meningomyelocele defect were transposed to close the defect. The flap donor sites were primarily sutured by elevating the surrounding skin. The left-sided flap was designed with superior pedicle and the right one with inferior pedicle. Of the participants, 13 were females and two were males with a mean age of 3.2 (min-max: 1 to 16) days. The mean follow-up was 11.5 (min-max: 5 to 17) months. The mean defect size was 6.5x5 (min-max: 5x4 to 7x6) cm. The mean flap size was 6.5x2.9 cm for the flap planned from the left side and right side of the defect. Complication was observed only in one patients including partial necrosis. Our study results suggest that modified S flap is an easily applicable flap. The greatest advantage of this flap is the shortening of the operation time. However, the major disadvantage of this flap is the random pattern flap (absence of a known blood vessel)