title: Delayed repair of large myelomeningoceles.
abstract: BACKGROUND
  Repair of myelomeningoceles larger than 5 cm in diameter is not easy. We describe a simple technique.
  
  
  METHODS
  The patients with a large myelomeningocele sac were included in this study. Ten patients with a large myelomeningocele underwent surgical repair using this technique. The skin was incised in the midline proximal to the myelomeningocele sac. The incision was carried caudally and away from the midline to open the sac after identifying the fascia. The incision is carried circumferentially around the neural placode and the skin is saved as much as possible. About a 1-cm-width of the dura mater beneath the skin is left to ease the subcutaneous suturing. The dura is sutured in the midline. The skin is undermined bilaterally in the plane between the muscle and subcutaneous fat and closed with interrupted sutures in the midline.
  
  
  CONCLUSIONS
  This simple technique is appropriate for the closure of large myelomeningoceles and does not need more extensive and complex procedures.
authors.affiliation: Division of Pediatric Neurosurgery, Ege University Faculty of Medicine, 35100 Bornova, Izmir, Turkey. ersahin@med.ege.edu.tr
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Erşahin
authors.forename: Taşkin
authors.initials: T
authors.lastname: Yurtseven
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008591:Meningomyelocele / Q000601:surgery*; D016137:Spina Bifida Cystica / Q000601:surgery*; D013524:Surgical Flaps; D013514:Surgical Procedures, Operative / Q000379:methods*; D013536:Suture Techniques