2024 Volume 15 Issue 2 Pages 71-77
Introduction: Spinal deformities associated with meningomyelocele, including thinning of the soft tissues in the lumbar region and scar contractures, can cause difficulty in posterior fusion wound closure, resulting in postoperative wound healing failure. In particular, with kyphosis, the skin of the bony prominence is in poor condition and may also be highly strained during closure, leading to postoperative wound necrosis. The lack of soft tissue coverage may result in deep infection due to poor wound healing, and further deep infection may lead to bone fusion failure, orthodontic loss, and implant failure.
Case Report: Two cases of skin necrosis and wound dehiscence after posterior corrective fusion for spinal deformity associated with meningomyelocele were treated with the gluteal artery perforator flap during reoperation: a 10-year-old female with kyphosis and a 35-year-old female with scoliosis. The latter was undergoing dialysis. In both cases, the wounds healed without developing deep infection.
Conclusions: Our results indicate that the gluteal artery perforator flap is an effective salvage technique to compensate for inadequate soft tissue at the lower lumbar level and to control wound healing and infection even in spinal deformities associated with meningomyelocele.
