Join us   Log in  


FRONTIERS IN MEDICAL CASE REPORTS - Volume 5; Issue 1, (Jan-Feb, 2024)

Pages: 01-08

Flap Necrosis After Large Myelomeningocele Repair Using Good Wound Care and Secondary Intention: Case report

Imad Talahma, Fida Hussien Al-Ali, Rama Subhi, Asala K. Hasani, Malak Yousef Jebril

Category: Medical Case Reports

Download PDF


Abstract Myelomeningocele (MMC) is the commonest type of neural tube defect; it represents a protrusion of neural tissue from a bony defect. Treatment of myelomeningocele depends on the size of the defect; with small ones, reconstruction with primary closure or local single flaps may be sufficient, while large (more than 5-8 cm) defects require more complicated reconstructive techniques. Flap necrosis is a major complication of large myelomeningocele repair. In our case, we discuss a new proposed method in post-surgical flap necrosis management based on good wound care, wound coverage, and healing by secondary intention.

Keywords: Disseminated Staphylococcal Infection, Staphylococcus Aureus, Pediatric Age, Acute Osteomyelitis, Deep Vein Thrombosis, Pulmonary Septic Embolisms


Adzick NS. Fetal myelomeningocele: natural history, pathophysiology, and in-utero intervention. Semin Fetal Neonatal Med 2010; 15: 9-14.?

Alruwaili AA. "Myelomeningocele" (2019).?

Dias LS, Swaroop VT, de Angeli LRA, Larson JE, Rojas AM, Karakostas T. Myelomeningocele: a new functional classification. J Child Orthop 2021; 15: 1-5

Farmer DL, Thom EA, Brock JW 3rd, Burrows PK, Johnson MP, Howell LJ, Farrell JA, Gupta N, Adzick NS; Management of Myelomeningocele Study Investigators. The Management of Myelomeningocele Study: full cohort 30-month pediatric outcomes. Am J Obstet Gynecol 2018; 218: 256.e1-256.e13.

Meller C, Covini D, Aiello H, Izbizky G, Portillo Medina S, Otaño L. Update on prenatal diagnosis and fetal surgery for myelomeningocele. Arch Argent Pediatr 2021; 119: e215-e228

Patel KB, Taghinia AH, Proctor MR, Warf BC, Greene AK. Extradural myelomeningocele reconstruction using local turnover fascial flaps and midline linear skin closure. J Plast Reconstr Aesthet Surg 2012; 65: 1569-1572.?

Ritonga DH, Siahaan AM. Comparison of Prenatal and Postnatal Management in Myelomeningocele: Literature Review. International Medical Journal 2022; 29: 233-236.?

Sahni M, Alsaleem M, Ohri A. Meningomyelocele. 2023 Sep 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.