Facilitating triple rhomboid flaps for meningomyelocele defect closure using a honeycomb structure as a template.

PURPOSE: Various reconstruction options are available for the soft-tissue coverage of meningomyelocele defects. For small defects, primary closure or local single flaps may be sufficient, while large defects require more complex reconstructive techniques. This study suggests an easy way for surgeons to close large meningomyelocele defects using triple rhomboid flaps.

METHODS

The hexagonal structure of a honeycomb was considered when planning for the coverage of large meningomyelocele defects. The intact skin around the defect was imagined as multiple hexagons, which allowed us to plan triple rhomboid flaps correctly and more easily. This technique was used in seven patients with defects ranging from 7 × 5 to 12 × 8 cm in size.

RESULTS

No major postoperative complications were seen. Minimal dehiscence was observed in two patients and healed secondarily.

CONCLUSIONS

The honeycomb modification for planning triple rhomboid flaps is an easy, practical, and memorable approach for surgeons reconstructing large meningomyelocele defects.