Simplifying soft tissue closure of the large meningomyelocele defect: a technical note.

The surgical management of large neural tube defects not amenable to primary closure poses a significant challenge. As a result, large residual skin defects often prompt excessively aggressive primary closure, complicated skin incisions, or flap advancements. However, our experience with the purse-string closure of a large meningomyelocele skin defect demonstrates that this technique can effectively provide coverage of very large meningomyelocele defects with minimal residual deformity. Here, we discuss the successful coverage of a large 5 x 5 cm meningomyelocele skin wound via staged purse-string closure spaced 2 weeks apart.