Lateral Sacral Artery Perforator Flap as a New Option in Myelomeningocele Reconstruction.

Abstract

Background: This study aims to present lateral sacral artery perforator (LSAP) flaps as a new option for myelomeningocele reconstruction and to discuss their advantages and disadvantages.

Methods: Eleven patients were included in the study, and reconstruction was performed with 22 LSAP flaps. Patients were evaluated in age, gender, birth weight, kyphosis status, defect localization and size, flap size, operation time, amount of bleeding, and postoperative complications.

Results: Sixteen flaps were raised from the first and 6 from the second LSA. The average time for soft tissue reconstruction was 57 minutes. The mean blood loss was 11.1 mL/kg. No cerebrospinal fluid leakage was detected in any patient. In 1 of the 22 flaps, venous congestion did not completely resolved and resulted in partial necrosis secondary to venous insufficiency. In 2 patients, minimal wound dehiscence was detected in the distal part of the flap. No wound infections, hematomas, donor site complications, or seromas were observed in any patient.

Conclusions: Considering that myelomeningoceles are often located in the lumbar region, we think that LSAP flaps will be a new option among other flaps. Additionally, if other flaps are used in the neonatal period, it may be a good alternative for pressure sore reconstruction in the kyphotic area.