title: Omentum and reverse turnover latissimus dorsi musculocutaneous flap for the treatment of cerebrospinal fluid fistula.
abstract: Conventional procedures can usually prevent cerebrospinal fluid (CSF) leakages, but they may not work for complicated cases. In this case presentation, we demonstrated the effectiveness of combined omental and latissimus dorsi musculocutaneous flaps for management of difficult CSF fistula. A reverse turnover latissimus dorsi musculocutaneous flap and omental flap were transferred for reconstruction of the posterior wound and CSF leakage. The omental flap component was used for CSF absorption, and the latissimus dorsi muscle component was used for obliteration of the dead space, covering of the exposed bone, and tension-free closure of the wound. The wound healed dramatically, with no observed severe donor site morbidity. The patient has been followed for 30 months with no evidence of CSF leakage and no pseudomeningocele formation, which was confirmed by magnetic resonance imaging (MRI). Although this is a case presentation, we can say that the combination of the omental and musculocutaneous flaps allow effective treatment and prevention of CSF fistulas in selected high-risk patients and provide durable coverage of complex spinal wounds.
authors.affiliation: Akdeniz University Faculty of Medicine, Department of Orthopedics and Traumatology, Antalya, Turkey.
authors.forename: Yetkin
authors.initials: Y
authors.lastname: Söyüncü
authors.affiliation: Akdeniz University Faculty of Medicine, Department of Anesthesiology and Reanimation, Antalya, Turkey.
authors.forename: Zekiye
authors.initials: Z
authors.lastname: Bigat
authors.affiliation: Antalya Training and Research Hospital, Department of Plastic Surgery, Antalya, Turkey.
authors.forename: İlkay
authors.initials: İ
authors.lastname: Söyüncü
authors.affiliation: Akdeniz University Faculty of Medicine, Department of Plastic Surgery, Antalya, Turkey.
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Özkan
mesh_terms: D000368:Aged; D065634:Cerebrospinal Fluid Leak / Q000601:surgery*; D017577:Cutaneous Fistula / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D064827:Myocutaneous Flap / Q000601:surgery*; D009852:Omentum / Q000601:surgery*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods; D064171:Superficial Back Muscles / Q000601:surgery*; D016896:Treatment Outcome