Skip to main content

Advertisement

SpringerLink
Log in

Negative pressure wound therapy for a large skin ulcer following repair of huge myeloschisis with kyphosis in a newborn

  • Case Report
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Background

In surgery of repair for spina bifida, various skin plastic techniques are sometimes necessary due to large skin defect or subsequent ulcers in cases when approximation on the midline is difficult.

Case report

A baby was born with a large skin defect due to huge lumbar myeloschisis and kyphosis, which was repaired 2 days after birth using Limberg’s skin flap at the peak of kyphosis. Skin ischemia around the tip of the flap gradually enlarged and resulted in a large skin ulcer. We performed negative pressure wound therapy (NPWT) using a Vacuum Assisted Closure (V.A.C.®) therapy system for 4 weeks which shrank the ulcer remarkably. Subsequently, a pedicle skin flap without graft was performed to cover the rest of the ulcer, which adapted well without CSF leakage postoperatively.

Conclusion

A combination treatment of NPWT and skin plastic surgery was successfully performed for a very young infant with spina bifida. NPWT could be another useful option for the treatment of ulcer following spina bifida repair surgery, though surgeons should carefully confirm that there is no CSF leakage before and during the procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Armstrong DG, Lavery LA (2005) Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomized controlled trial. Lancet 366:1704–1710

    Article  PubMed  Google Scholar 

  2. Caniano DA, Ruth B, Teich S (2005) Wound management with vacuum-assisted closure: experience in 51 pediatric patients. J Pediat Surg 40:128–132

    Article  PubMed  Google Scholar 

  3. Cruz NI, Ariyan S, Duncan CC, Cuono CB (1983) Repair of lumbosacral myelomeningoceles with double Z-rhomboid flaps. Technical note. J Neurosurg 59:714–717

    Article  PubMed  CAS  Google Scholar 

  4. Damiani G, Pinnarelli L, Sommella L, Tocco MP, Marvulli M, Magrini P, Ricciardi W (2011) Vacuum-assisted closure therapy for patients with infected sterna wounds: a meta-analysis of current evidence. J Plast Reconstr Aesthet Surg 64:1119–1123

    Article  PubMed  CAS  Google Scholar 

  5. Eginton MT, Brown KR, Seabrook GR, Towne JB, Cambria RA (2003) A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds. Ann Vasc Surg 17:645–649

    Article  PubMed  Google Scholar 

  6. Gupta S, Baharestani M, Baranoski S, de Leon J, Engel SJ, Mendez-Eastman S, Niezgoda JA, Pompeo MQ (2004) Guidelines for managing pressure ulcers with negative pressure wound therapy. Adv Skin Wound Care 17(Suppl 2):1–16

    Article  PubMed  Google Scholar 

  7. Kanakaris NK, Thanasas C, Keramaris N, Kontakis G, Granick MS, Giannoudis PV (2007) The efficacy of negative pressure wound therapy in the management of lower extremity trauma: review of clinical evidence. Injury 38(S8–10):S11–S17

    Google Scholar 

  8. Kose KC, Inanmaz ME, Uslu M, Bal E, Caliskan I (2012) Kyphectomy for congenital kyphosis due to meningomyelocele: a case treated with a modified approach to skin healing. Int Wound J 9:311–315

    Article  PubMed  Google Scholar 

  9. Milsaidi N (2010) Negative pressure wound therapy. Use with care. Nursing 40:64–66

    Article  Google Scholar 

  10. Mutaf M, Bekerecioglu M, Erkutulu I, Bulut O (2007) A new technique for closure of large meningomyelocele defects. Ann Plast Surg 59:538–543

    Article  PubMed  CAS  Google Scholar 

  11. O’Meara S, Cullum NA, Nelson EA (2009) Compression for venous leg ulcers. Cochrane Database Syst Rev. doi:10.1002/14651858

    PubMed  Google Scholar 

  12. Othman D (2012) Negative pressure wound therapy literature review of efficacy, cost effectiveness, and impact on patients’ quality of life in chronic wound management and its implementation in the United Kingdom. Plastic Surg Int 2012:374398. doi:10.1155/2012/374398

    Google Scholar 

  13. Veir Z, Dudukovic M, Miklic P, Mijatoviv D, Cvjeticanin B, Veir M, Dujmovic A (2011) Reconstruction of a soft tissue defect of the back after myelomeningocele closure with modified V-Y plasty. Coll Antropol 35:1295–1298

    PubMed  Google Scholar 

  14. Webster J, Scuffham P, Sherriff KL, Stankiewicz M, Chaboyer WP (2012) Negative pressure wound therapy for skin grafts and surgical wounds healing by primary intention. Cochrane Database Syst Rev. Doi:10.1002/14651858

Download references

Conflict of interest

The authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Hiroyuki Katano, Yusuke Nishikawa & Kazuo Yamada

  2. Department of Medical Informatics and Integrative Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Hiroyuki Katano

  3. Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Koichi Ito

  4. Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Akimichi Morita

  5. Department of Plastic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Kazuhiro Toriyama & Yuzuru Kamei

Authors
  1. Hiroyuki Katano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazuhiro Toriyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yusuke Nishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Koichi Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Akimichi Morita
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuzuru Kamei
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kazuo Yamada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroyuki Katano.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Katano, H., Toriyama, K., Nishikawa, Y. et al. Negative pressure wound therapy for a large skin ulcer following repair of huge myeloschisis with kyphosis in a newborn. Childs Nerv Syst 29, 2295–2299 (2013). https://doi.org/10.1007/s00381-013-2166-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-013-2166-9

Keywords

Search

Navigation