The deepithelialized skin flap for closure of large myelomeningoceles: a common plastic surgery technique for a novel neurosurgery application.
OBJECTIVE
The study aims to demonstrate proof of principle of a common plastic surgery technique of deepithelialization for repair of large myelomeningoceles (MMCs). Whereas repair typically consists of a watertight dural closure followed by a muscle or fasciocutaeneous layer, excess skin, however, need not be discarded and can be deepithelialized to augment or, in selective cases, replace the muscle repair.


METHODS
The study was performed through a retrospective chart review of two patients.


RESULTS
Step-by-step figures illustrate the technique. Two patients each born with large MMCs measuring 10 × 11 cm and 6 × 9 cm, respectively, were reviewed. Excess skin was deepithelialized to create an additional layer of vascularized tissue over the muscle repair. There were no post-operative complications at 3-month follow-up.


CONCLUSIONS
In large MMCs with excess skin, the use of a deepithelialized skin flap can potentially be an alternative or adjunct to a muscle flap to buttress the dural repair.
Division of Plastic Surgery, Department of Surgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, 1 Children's Way, Little Rock, AR, 72202, USA. msgolinko@uams.edu.
Michael S
MS
Golinko
Division of Plastic Surgery, Department of Surgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, 1 Children's Way, Little Rock, AR, 72202, USA.
Kumar
K
Patel
Department of Neurosurgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, 1 Children's Way, Little Rock, AR, 72202, USA.
Rong
R
Cai
Division of Plastic Surgery, Department of Surgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, 1 Children's Way, Little Rock, AR, 72202, USA.
Aaron
A
Smith
Department of Neurosurgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, 1 Children's Way, Little Rock, AR, 72202, USA.
Eylem
E
Ocal
D000328:Adult; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008591:Meningomyelocele / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013518:Surgery, Plastic / Q000379:methods*; D013524:Surgical Flaps
Deepithelialized flap; Myelomeningocele repair