title: Facilitating triple rhomboid flaps for meningomyelocele defect closure using a honeycomb structure as a template.
abstract: OBJECTIVE
  Various reconstruction options are available for the soft-tissue coverage of meningomyelocele defects. For small defects, primary closure or local single flaps may be sufficient, while large defects require more complex reconstructive techniques. This study suggests an easy way for surgeons to close large meningomyelocele defects using triple rhomboid flaps.
  
  
  METHODS
  The hexagonal structure of a honeycomb was considered when planning for the coverage of large meningomyelocele defects. The intact skin around the defect was imagined as multiple hexagons, which allowed us to plan triple rhomboid flaps correctly and more easily. This technique was used in seven patients with defects ranging from 7 × 5 to 12 × 8 cm in size.
  
  
  RESULTS
  No major postoperative complications were seen. Minimal dehiscence was observed in two patients and healed secondarily.
  
  
  CONCLUSIONS
  The honeycomb modification for planning triple rhomboid flaps is an easy, practical, and memorable approach for surgeons reconstructing large meningomyelocele defects.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Karacor-Altuntas
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Dadaci
authors.affiliation: Department of Neurosurgery, School of the Medicine, Necmettin Erbakan University, 42080, Meram, Konya, Turkey. mfatiherdi@hotmail.com.
authors.forename: Fatih
authors.initials: F
authors.lastname: Erdi
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Bilsev
authors.initials: B
authors.lastname: Ince
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Uyar
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, School of the Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Yarar
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D008591:Meningomyelocele / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps
keywords: Meningomyelocele; Surgical flaps; Techniques; Wound closure