Long-term follow-up for keystone design perforator island flap for closure of myelomeningocele
Purpose We have previously reported a small series on the closure of large myelomeningocele (MMC) defects with a keystone design perforator island flap (KDPIF) in a paediatric neurosurgical centre in Australia. We are now presenting an updated longer term follow-up of an expanded series demonstratin...
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| Veröffentlicht in: | Child's nervous system 2018-04, Vol.34 (4), p.733-736 |
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| creator | Donaldson, Christopher Murday, Hamsaveni K. M. Gutman, Matthew J. Maher, Rory Goldschlager, Tony Xenos, Chris Danks, R. Andrew |
| description | Purpose
We have previously reported a small series on the closure of large myelomeningocele (MMC) defects with a keystone design perforator island flap (KDPIF) in a paediatric neurosurgical centre in Australia. We are now presenting an updated longer term follow-up of an expanded series demonstrating longer term durability of this vascularized flap for large myelomeningocele defects.
Methods
The prospective data from the Monash Neurosurgical Database were used to select all cases of MMC between December 2008 and September 2016. Retrospective analysis of the neurosurgical database revealed an additional three patients who underwent KDPIF closure at the Monash Medical Centre for MMC repair at birth.
Results
Wound healing was satisfactory in all six cases. With delayed follow-up, there was no associated skin flap separation, skin flap dehiscence, skin flap necrosis, cerebro-spinal fluid leak, however two infections were encountered, both resolved with conservative management including antibiotics and simple washout.
Conclusion
In this expanded case series with increased longevity of follow-up, the keystone design perforator island flap remains a robust alternative for closure of large myelomeningocele defects. |
| doi_str_mv | 10.1007/s00381-017-3697-2 |
| format | Article |
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We have previously reported a small series on the closure of large myelomeningocele (MMC) defects with a keystone design perforator island flap (KDPIF) in a paediatric neurosurgical centre in Australia. We are now presenting an updated longer term follow-up of an expanded series demonstrating longer term durability of this vascularized flap for large myelomeningocele defects.
Methods
The prospective data from the Monash Neurosurgical Database were used to select all cases of MMC between December 2008 and September 2016. Retrospective analysis of the neurosurgical database revealed an additional three patients who underwent KDPIF closure at the Monash Medical Centre for MMC repair at birth.
Results
Wound healing was satisfactory in all six cases. With delayed follow-up, there was no associated skin flap separation, skin flap dehiscence, skin flap necrosis, cerebro-spinal fluid leak, however two infections were encountered, both resolved with conservative management including antibiotics and simple washout.
Conclusion
In this expanded case series with increased longevity of follow-up, the keystone design perforator island flap remains a robust alternative for closure of large myelomeningocele defects.</description><identifier>ISSN: 0256-7040</identifier><identifier>EISSN: 1433-0350</identifier><identifier>DOI: 10.1007/s00381-017-3697-2</identifier><identifier>PMID: 29255922</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Child, Preschool ; Female ; Humans ; Infant ; Longitudinal Studies ; Male ; Medicine ; Medicine & Public Health ; Meningomyelocele - surgery ; Neurosciences ; Neurosurgery ; Original Paper ; Perforator Flap - surgery ; Reconstructive Surgical Procedures - instrumentation ; Reconstructive Surgical Procedures - methods ; Retrospective Studies ; Treatment Outcome ; Wound Healing</subject><ispartof>Child's nervous system, 2018-04, Vol.34 (4), p.733-736</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c344t-743f9f968fa5fb138377276e59724a6e1ebc2a5d854f9405357eb50247206c753</citedby><cites>FETCH-LOGICAL-c344t-743f9f968fa5fb138377276e59724a6e1ebc2a5d854f9405357eb50247206c753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00381-017-3697-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00381-017-3697-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29255922$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Donaldson, Christopher</creatorcontrib><creatorcontrib>Murday, Hamsaveni K. M.</creatorcontrib><creatorcontrib>Gutman, Matthew J.</creatorcontrib><creatorcontrib>Maher, Rory</creatorcontrib><creatorcontrib>Goldschlager, Tony</creatorcontrib><creatorcontrib>Xenos, Chris</creatorcontrib><creatorcontrib>Danks, R. Andrew</creatorcontrib><title>Long-term follow-up for keystone design perforator island flap for closure of myelomeningocele</title><title>Child's nervous system</title><addtitle>Childs Nerv Syst</addtitle><addtitle>Childs Nerv Syst</addtitle><description>Purpose
We have previously reported a small series on the closure of large myelomeningocele (MMC) defects with a keystone design perforator island flap (KDPIF) in a paediatric neurosurgical centre in Australia. We are now presenting an updated longer term follow-up of an expanded series demonstrating longer term durability of this vascularized flap for large myelomeningocele defects.
Methods
The prospective data from the Monash Neurosurgical Database were used to select all cases of MMC between December 2008 and September 2016. Retrospective analysis of the neurosurgical database revealed an additional three patients who underwent KDPIF closure at the Monash Medical Centre for MMC repair at birth.
Results
Wound healing was satisfactory in all six cases. With delayed follow-up, there was no associated skin flap separation, skin flap dehiscence, skin flap necrosis, cerebro-spinal fluid leak, however two infections were encountered, both resolved with conservative management including antibiotics and simple washout.
Conclusion
In this expanded case series with increased longevity of follow-up, the keystone design perforator island flap remains a robust alternative for closure of large myelomeningocele defects.</description><subject>Child, Preschool</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meningomyelocele - surgery</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original Paper</subject><subject>Perforator Flap - surgery</subject><subject>Reconstructive Surgical Procedures - instrumentation</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Wound Healing</subject><issn>0256-7040</issn><issn>1433-0350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1PwzAQhi0EoqXwA1hQRhbD-SuOR1TxJVVigRUrSc9VShIXOxHqv8dVgJHprLvnXp0fQi4Z3DAAfRsBRMEoME1FbjTlR2TOpBAUhIJjMgeucqpBwoycxbgFYKrg5pTMuOFKGc7n5H3l-w0dMHSZ823rv-i4S6-QfeA-Dr7HbI2x2fTZDkNql0MaNbEt-3Xm2nJC69bHMWDmXdbtsfUd9k2_8TW2eE5OXNlGvPipC_L2cP-6fKKrl8fn5d2K1kLKgWopnHEmL1ypXMVEIbTmOkdlNJdljgyrmpdqXSjpjAQllMZKAZeaQ15rJRbkesrdBf85Yhxs18R0QDoU_RgtM7rQQiqtE8omtA4-xoDO7kLTlWFvGdiDVjtptUmrPWi1PO1c_cSPVYfrv41fjwngExDTqN9gsFs_hj59-Z_UbyB0gtg</recordid><startdate>20180401</startdate><enddate>20180401</enddate><creator>Donaldson, Christopher</creator><creator>Murday, Hamsaveni K. M.</creator><creator>Gutman, Matthew J.</creator><creator>Maher, Rory</creator><creator>Goldschlager, Tony</creator><creator>Xenos, Chris</creator><creator>Danks, R. Andrew</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180401</creationdate><title>Long-term follow-up for keystone design perforator island flap for closure of myelomeningocele</title><author>Donaldson, Christopher ; Murday, Hamsaveni K. M. ; Gutman, Matthew J. ; Maher, Rory ; Goldschlager, Tony ; Xenos, Chris ; Danks, R. Andrew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c344t-743f9f968fa5fb138377276e59724a6e1ebc2a5d854f9405357eb50247206c753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Child, Preschool</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meningomyelocele - surgery</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Original Paper</topic><topic>Perforator Flap - surgery</topic><topic>Reconstructive Surgical Procedures - instrumentation</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Donaldson, Christopher</creatorcontrib><creatorcontrib>Murday, Hamsaveni K. M.</creatorcontrib><creatorcontrib>Gutman, Matthew J.</creatorcontrib><creatorcontrib>Maher, Rory</creatorcontrib><creatorcontrib>Goldschlager, Tony</creatorcontrib><creatorcontrib>Xenos, Chris</creatorcontrib><creatorcontrib>Danks, R. Andrew</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Child's nervous system</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Donaldson, Christopher</au><au>Murday, Hamsaveni K. M.</au><au>Gutman, Matthew J.</au><au>Maher, Rory</au><au>Goldschlager, Tony</au><au>Xenos, Chris</au><au>Danks, R. Andrew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term follow-up for keystone design perforator island flap for closure of myelomeningocele</atitle><jtitle>Child's nervous system</jtitle><stitle>Childs Nerv Syst</stitle><addtitle>Childs Nerv Syst</addtitle><date>2018-04-01</date><risdate>2018</risdate><volume>34</volume><issue>4</issue><spage>733</spage><epage>736</epage><pages>733-736</pages><issn>0256-7040</issn><eissn>1433-0350</eissn><abstract>Purpose
We have previously reported a small series on the closure of large myelomeningocele (MMC) defects with a keystone design perforator island flap (KDPIF) in a paediatric neurosurgical centre in Australia. We are now presenting an updated longer term follow-up of an expanded series demonstrating longer term durability of this vascularized flap for large myelomeningocele defects.
Methods
The prospective data from the Monash Neurosurgical Database were used to select all cases of MMC between December 2008 and September 2016. Retrospective analysis of the neurosurgical database revealed an additional three patients who underwent KDPIF closure at the Monash Medical Centre for MMC repair at birth.
Results
Wound healing was satisfactory in all six cases. With delayed follow-up, there was no associated skin flap separation, skin flap dehiscence, skin flap necrosis, cerebro-spinal fluid leak, however two infections were encountered, both resolved with conservative management including antibiotics and simple washout.
Conclusion
In this expanded case series with increased longevity of follow-up, the keystone design perforator island flap remains a robust alternative for closure of large myelomeningocele defects.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29255922</pmid><doi>10.1007/s00381-017-3697-2</doi><tpages>4</tpages></addata></record> |
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| ispartof | Child's nervous system, 2018-04, Vol.34 (4), p.733-736 |
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| source | MEDLINE; SpringerLink Journals (MCLS) |
| subjects | Child, Preschool Female Humans Infant Longitudinal Studies Male Medicine Medicine & Public Health Meningomyelocele - surgery Neurosciences Neurosurgery Original Paper Perforator Flap - surgery Reconstructive Surgical Procedures - instrumentation Reconstructive Surgical Procedures - methods Retrospective Studies Treatment Outcome Wound Healing |
| title | Long-term follow-up for keystone design perforator island flap for closure of myelomeningocele |
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