D. Gahankari et al., UNILATERAL REVERSE LATISSIMUS-DORSI MUSCLE FLAP FOR POSTOPERATIVE CSFLEAK AND WOUND DEHISCENCE IN LUMBOSACRAL DEFECTS - A LIFEBOAT APPROACH, Journal of clinical neuroscience, 5(4), 1998, pp. 433-435
A lumbosacral defect with cerebrospinal fluid (CSF) leak, particularly
after breakdown of a repaired lipomeningomyelocele, is often a diffic
ult problem to manage. Although several methods of local flap coverage
have been used, local wound infection and tissue cellulitis associate
d with the wound dehiscence makes the repair prone to redehiscence, Th
e associated CSF leak requires a good reliable closure as a matter of
urgency. We describe two patients with lipomeningomyelocele, operated
upon for tethered cord syndrome, who developed postoperative CSF leak
and wound dehiscence, The associated wound infection and signs of meni
ngitis made re-exploration, debridement and a dependable, well vascula
rized cover of the dura mandatory. The reverse latissimus dorsi flap p
rovided a good vascularized seal. Both patients recovered rapidly. Jou
rnal of Clinical Neuroscience (1998) 5(4), 433-435 (C) Harcourt Brace
& Co. Ltd 1998