척수수막류 결손 재건을 위한 양측 V - Y 전진 피판술 (Bilateral Fasciocutaneous Sliding V - Y Advancement Flap for Meningomyelocele Defect)

서지정보

· 발행기관 : 대한성형외과학회
· 수록지 정보 : Archives of Plastic Surgery / 37권 / 6호 / 823 ~ 826페이지
· 저자명 : 신종원, 오득영, 이중호, 문석호, 서제원, 이종원, 안상태

초록

Purpose: Meningomyelocele is the most common type of neural tube defect disease. Early surgical treatment is recommended to prevent central nervous system infection. Several reconstruction methods were reported previously regarding surgical wound defect closure following meningomyelocele excision. In this article, we report two successful patients using the bilateral fasciocutaneous sliding V - Y advancement flap as a covering for meningomyelocele defects.
Methods: Two patients with meningomyelocele were evaluated. Both patients were male and received their operations on day 1 and day 4 of life. After neurosurgeons completed their part of the operation, the V - Y advancement flap was used to close the defect. Initially a bilateral V - shape incision design was made on the skin such that the base of the V - flap measures identical to the size of the wound defect. An incision was made down to the fascia in order to allow the V - flaps to slide into the defect. Subfascial dissection was performed up to 1 / 3 – 1 / 4 the length of the V-flap from the wound while minimizing injury to the perforating vessels.
Results: Both patients were treated successfully and there was no evidence of complication in 2 months follow up.
Conclusion: Several reconstruction methods such as local flaps, skin graft and myocutaneous flaps were reported regarding meningomyelocele surgical wound defect closure. Bilateral fasciocutaneous sliding V - Y advancement flap is an easy method without involving the underlying muscles or a secondary skin graft in a short operation time. Therefore we recommend this treatment option for reconstruction of the wound defect following meningomyelocele excision.

영어초록

Purpose: Meningomyelocele is the most common type of neural tube defect disease. Early surgical treatment is recommended to prevent central nervous system infection. Several reconstruction methods were reported previously regarding surgical wound defect closure following meningomyelocele excision. In this article, we report two successful patients using the bilateral fasciocutaneous sliding V - Y advancement flap as a covering for meningomyelocele defects.
Methods: Two patients with meningomyelocele were evaluated. Both patients were male and received their operations on day 1 and day 4 of life. After neurosurgeons completed their part of the operation, the V - Y advancement flap was used to close the defect. Initially a bilateral V - shape incision design was made on the skin such that the base of the V - flap measures identical to the size of the wound defect. An incision was made down to the fascia in order to allow the V - flaps to slide into the defect. Subfascial dissection was performed up to 1 / 3 – 1 / 4 the length of the V-flap from the wound while minimizing injury to the perforating vessels.
Results: Both patients were treated successfully and there was no evidence of complication in 2 months follow up.
Conclusion: Several reconstruction methods such as local flaps, skin graft and myocutaneous flaps were reported regarding meningomyelocele surgical wound defect closure. Bilateral fasciocutaneous sliding V - Y advancement flap is an easy method without involving the underlying muscles or a secondary skin graft in a short operation time. Therefore we recommend this treatment option for reconstruction of the wound defect following meningomyelocele excision.

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