Delayed repair of large myelomeningoceles.

摘要

INTRODUCTION: Repair of myelomeningoceles larger than 5 cm in diameter is not easy. We describe a simple technique. PATIENTS AND METHODS: The patients with a large myelomeningocele sac were included in this study. Ten patients with a large myelomeningocele underwent surgical repair using this technique. The skin was incised in the midline proximal to the myelomeningocele sac. The incision was carried caudally and away from the midline to open the sac after identifying the fascia. The incision is carried circumferentially around the neural placode and the skin is saved as much as possible. About a 1-cm-width of the dura mater beneath the skin is left to ease the subcutaneous suturing. The dura is sutured in the midline. The skin is undermined bilaterally in the plane between the muscle and subcutaneous fat and closed with interrupted sutures in the midline. CONCLUSION: This simple technique is appropriate for the closure of large myelomeningoceles and does not need more extensive and complex procedures.