Use of the bovine pericardial patch and fibrin sealant in meningomyelocele closure.
BACKGROUND
Meningomyelocele is the most common and complex birth defect of the central nervous system. The operative principle of meningomyelocele repair consists of consecutive separate closures of the neural placode, dura mater, lumbar fascia, subcutaneous layer, and skin. While the neurosurgical techniques for the closure of the neural placode and dura mater have been well accepted, the most appropriate soft tissue closure technique has not yet been applied.


METHODS
This study reviews a case series of eight meningomyelocele patients treated with the bovine pericardial patch and fibrin sealant. Following the reconstruction of the neural placode and the closure of the dura mater, soft tissue coverage was achieved using the bovine pericardial patch and fibrin sealant.


RESULTS
In this series of eight patients, stable coverage was achieved with the application of a bovine pericardial patch and fibrin sealant technique. After the operations, none of the possible complications such as cerebrospinal fluid leak, seroma, hematoma, skin necrosis, deep or superficial infection, and wound breakdown was observed.


CONCLUSIONS
The usage of the bovine pericardial patch and fibrin sealant technique at the fascial level-between the dural sac and the skin-provides adequate soft tissue coverage in meningomyelocele repair surgery.
Ministry of Health, Fatih Sultan Mehmet Education and Research Hospital, Neurosurgery Clinic, S.B. Fatih Sultan Mehmet Egitim ve Arastirma Hastanesi, Beyin Cerrahi Servisi, 34752, Ataşehir, Istanbul, Turkey, boragurer@gmail.com.
Bora
B
Gürer
Hayri
H
Kertmen
Umut Dogu
UD
Akturk
Mehmet
M
Kalan
Zeki
Z
Sekerci
D000818:Animals; D002417:Cattle; D004388:Dura Mater / Q000601:surgery; D005260:Female; D015718:Fibrin Tissue Adhesive; D006801:Humans; D007223:Infant; D008297:Male; D008591:Meningomyelocele / Q000601:surgery*; D010496:Pericardium; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000379:methods*
D015718:Fibrin Tissue Adhesive