BACKGROUND: In surgery of repair for spina bifida, various skin plastic techniques are sometimes necessary due to large skin defect or subsequent ulcers in cases when approximation on the midline is difficult. CASE REPORT: A baby was born with a large skin defect due to huge lumbar myeloschisis and kyphosis, which was repaired 2 days after birth using Limberg's skin flap at the peak of kyphosis. Skin ischemia around the tip of the flap gradually enlarged and resulted in a large skin ulcer. We performed negative pressure wound therapy (NPWT) using a Vacuum Assisted Closure (V.A.C.®) therapy system for 4 weeks which shrank the ulcer remarkably. Subsequently, a pedicle skin flap without graft was performed to cover the rest of the ulcer, which adapted well without CSF leakage postoperatively. CONCLUSION: A combination treatment of NPWT and skin plastic surgery was successfully performed for a very young infant with spina bifida. NPWT could be another useful option for the treatment of ulcer following spina bifida repair surgery, though surgeons should carefully confirm that there is no CSF leakage before and during the procedure.
BACKGROUND: In surgery of repair for spina bifida, various skin plastic techniques are sometimes necessary due to large skin defect or subsequent ulcers in cases when approximation on the midline is difficult. CASE REPORT: A baby was born with a large skin defect due to huge lumbar myeloschisis and kyphosis, which was repaired 2 days after birth using Limberg's skin flap at the peak of kyphosis. Skin ischemia around the tip of the flap gradually enlarged and resulted in a large skin ulcer. We performed negative pressure wound therapy (NPWT) using a Vacuum Assisted Closure (V.A.C.®) therapy system for 4 weeks which shrank the ulcer remarkably. Subsequently, a pedicle skin flap without graft was performed to cover the rest of the ulcer, which adapted well without CSF leakage postoperatively. CONCLUSION: A combination treatment of NPWT and skin plastic surgery was successfully performed for a very young infant with spina bifida. NPWT could be another useful option for the treatment of ulcer following spina bifida repair surgery, though surgeons should carefully confirm that there is no CSF leakage before and during the procedure.
Authors: Subhas Gupta; Mona Baharestani; Sharon Baranoski; Jean de Leon; Scott J Engel; Susan Mendez-Eastman; Jeffery A Niezgoda; Matthew Q Pompeo Journal: Adv Skin Wound Care Date: 2004 Nov-Dec Impact factor: 2.347
Authors: Mark T Eginton; Kellie R Brown; Gary R Seabrook; Jonathan B Towne; Robert A Cambria Journal: Ann Vasc Surg Date: 2003-10-13 Impact factor: 1.466
Authors: Katherine B Santosa; Matt Keller; Margaret A Olsen; Alexandra M Keane; Erika D Sears; Alison K Snyder-Warwick Journal: J Surg Res Date: 2018-11-30 Impact factor: 2.192