In utero Plastic Surgery in Zurich: Successful Use of Distally Pedicled Random Pattern Transposition Flaps for Definitive Skin Closure during Open Fetal Spina Bifida Repair.
Fetal Diagn Ther
; 44(3): 173-178, 2018.
Article
in En
| MEDLINE
| ID: mdl-29258087
ABSTRACT
BACKGROUND:
One of the intraoperative challenges of fetal spina bifida repair is skin closure when there is an extended skin defect. Thus, we examined whether distally pedicled random pattern transposition flaps (TFs) are a valid option to overcome this problem. SUBJECTS ANDMETHODS:
All patients undergoing in utero repair of spina bifida with application of a TF for back skin closure were analyzed focusing on intraoperative flap characteristics and postoperative flap performance.RESULTS:
In 30 (70%) of the 43 fetuses a primary skin closure was achieved, in 5 (12%) a skin substitute was used, and in 8 (18%) a TF was applied. Flap raising and insertion was uneventful and perfusion was sufficient in all 8 fetuses (100%). In 3 fetuses (37%) the donor sites were closed primarily, and in 5 (63%) a skin substitute was used for coverage. At birth, 7 flaps were viable and provided robust skin coverage over the center of the former lesion. Complications included a small skin defect with CSF leakage in 1 patient (13%).CONCLUSION:
During open fetal spina bifida repair, TFs can be safely and efficaciously used to obtain solid and durable skin coverage over lesions too large to allow conventional primary skin closure.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Surgery, Plastic
/
Spinal Dysraphism
/
Meningomyelocele
/
Fetus
Type of study:
Clinical_trials
Limits:
Female
/
Humans
/
Pregnancy
Country/Region as subject:
Europa
Language:
En
Journal:
Fetal Diagn Ther
Journal subject:
DIAGNOSTICO POR IMAGEM
/
OBSTETRICIA
/
PERINATOLOGIA
Year:
2018
Type:
Article
Affiliation country:
Switzerland