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Journals / Ağrı Tıp Fakültesi Dergisi / 2026 / Cilt: 4 Sayı: 2

Reconstruction of large meningomyelocele defects using the keystone flap: A retrospective case series

Keystone flep kullanılarak geniş meningomyelosel defektlerinin rekonstrüksiyonu: Retrospektif bir olgu serisi

Abdulkadir Calavul(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ESKİŞEHİR ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ)0000-0002-6790-128X
Pages
63–71
Publication Date
2026-06-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Further studies with larger sample sizes are needed to confirm its effectiveness and safety.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: This study aimed to evaluate the clinical outcomes and complication rates associated with the keystone design perforator flap technique for the surgical reconstruction of large meningomyelocele defects in neonates.
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Key Findings & Data:Materials and Methods: A retrospective analysis was conducted on 10 neonates who underwent meningomyelocele repair using the keystone flap technique between 2022 and 2023.
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Conclusion & Impact:Further studies with larger sample sizes are needed to confirm its effectiveness and safety.
🔬Design:Araştırma Makalesi
📍Scope:2022 Verileri
⚙️Variables:Klinik sonuçlar · Keystone flep · yenidoğan

Abstract

Aim: This study aimed to evaluate the clinical outcomes and complication rates associated with the keystone design perforator flap technique for the surgical reconstruction of large meningomyelocele defects in neonates. Materials and Methods: A retrospective analysis was conducted on 10 neonates who underwent meningomyelocele repair using the keystone flap technique between 2022 and 2023. Demographic and clinical variables, including sex, gestational age, birth weight, maternal age, presence of consanguinity, defect localization and size, day of surgery, hospital stay duration, and postoperative complications were recorded. Descriptive statistics were used, and comparisons between groups with and without complications were performed using the Mann–Whitney U test and Fisher's exact test. Results: All patients achieved successful wound closure without major flap loss or CSF leakage. No statistically significant associations were found between postoperative complications and the evaluated clinical variables (p > .05). The median defect size was 228.0 cm² (IQR: 180.0–297.0 cm²), and the median hospital stay was 63.5 days (IQR: 49.25–77.25 days). Postoperative complications were observed in 4 patients (40%) and were managed conservatively without the need for flap revision. Conclusion: The keystone flap may be a feasible option for the reconstruction of large meningomyelocele defects in neonates. Further studies with larger sample sizes are needed to confirm its effectiveness and safety.

Özet

Amaç: Bu çalışma, yenidoğanlarda büyük meningomiyelosel defektlerinin cerrahi rekonstrüksiyonunda keystone tasarımlı perforatör flep tekniğine bağlı klinik sonuçları ve komplikasyon oranlarını değerlendirmeyi amaçlamaktadır. Gereçler ve Yöntemler: 2022–2023 yılları arasında keystone flep tekniği kullanılarak meningomiyelosel onarımı yapılan 10 yenidoğan retrospektif olarak incelendi. Cinsiyet, gestasyonel yaş, doğum ağırlığı, anne yaşı, akraba evliliği varlığı, defektin lokalizasyonu ve boyutu, ameliyat günü, hastanede yatış süresi ve postoperatif komplikasyonlar gibi demografik ve klinik değişkenler kaydedildi. Tanımlayıcı istatistikler kullanıldı ve komplikasyon gelişen ve gelişmeyen gruplar arasındaki karşılaştırmalar Mann–Whitney U testi ve Fisher Exact testi kullanılarak yapıldı. Bulgular: Tüm hastalarda majör flep kaybı veya BOS kaçağı olmaksızın başarılı yara kapanması sağlandı. Komplikasyon gelişimi ile değerlendirilen klinik değişkenlerin hiçbiri (örneğin doğum ağırlığı, defekt boyutu, cerrahi zamanlama) arasında istatistiksel olarak anlamlı bir ilişki saptanmadı (p > 0,05). Median defekt boyutu 228,0 cm² (IQR: 180,0–297,0 cm²), median hastanede yatış süresi ise 63,5 gün (IQR: 49,25–77,25 gün) olarak belirlendi. Postoperatif komplikasyonlar 4 hastada (%40) görüldü ve flep revizyonu gerektirmeden konservatif olarak yönetildi. Sonuç: Keystone flep, yenidoğanlarda büyük meningomiyelosel defektlerinin rekonstrüksiyonunda uygulanabilir bir seçenek olabilir. Bu tekniğin etkinliği ve güvenilirliğini doğrulamak için daha geniş örneklemli çalışmalara ihtiyaç vardır.

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Cite This Article

Calavul, A. (2026). Reconstruction of large meningomyelocele defects using the keystone flap: A retrospective case series. Ağrı Tıp Fakültesi Dergisi, Cilt: 4 Sayı: 2, 63–71. https://doi.org/10.61845/agrimedical.1869957

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