title: A new technique for closure of large meningomyelocele defects.
abstract: BACKGROUND
  Although small meningomyeloceles may be amenable to direct closure by undermining of the surrounding skin, the closure of large meningomyelocele defects is a challenging reconstructive problem.
  
  
  OBJECTIVE
  Here, we present a new surgical procedure for the closure of large meningomyelocele defects.
  
  
  METHODS
  In this procedure, after neurosurgical repair and closure of the placode, the defect is surgically converted to a triangle in shape. Then, the triangular defect is closed by transposition of 2 skin flaps designed in an unequal z-plasty manner. Over 3 years, this new technique, namely Mutaf triangular closure procedure, was used for the closure of large meningomyelocele defects in 5 patients, aged between 2 days to 6 weeks. The defect size was 10.4 x 7.5 cm on average.
  
  
  RESULTS
  In all patients, a tension-free 1-stage closure was obtained. Except one with a minimal hematoma, all patients healed with no complication. There was no patient with late breakdown of the wound during 2 years of mean follow-up.
  
  
  CONCLUSIONS
  Besides the 2 major advantages of short operative time and minimal blood loss, our technique provides a well-vascularized soft tissue padding over the neural tissues, and no suture line overlies the cord closure. With these advantages, this new technique seems to be a useful and safe solution for closure of large meningomyelocele defects.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey. doctormutaf@yahoo.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Mutaf
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bekerecioğlu
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Erkutlu
authors.forename: Omer
authors.initials: O
authors.lastname: Bulut
mesh_terms: D002490:Central Nervous System / Q000002:abnormalities*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008591:Meningomyelocele / Q000601:surgery*; D009432:Neural Crest / Q000473:pathology*; D019651:Plastic Surgery Procedures; D013518:Surgery, Plastic / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome