Abstract

AbstractThe description of reconstructive surgical procedures in myelodysplasia focuses on surgical management of skin closure following removal of the myelomeningacele. Skin closure procedure consists of the construction of large, wide-based, double rotation flaps of skin and subcutaneous fat on both sides of the opening which are undermined widely to permit tension-free closing of the wound in a large “S” shape. If the wound is very large, split-thickness skin grafts can be used. Collaboration of various health service personnel is necessary to avoid such complications as pressure sores and ulcers, or to ensure their successful treatment. To achieve effective surgical management of pressure sores, a frequent complication in all instances of paraplegia, one must consider the patient's nutritional state, and possible anemia, control of spasms, and prevention of additional pressure sores. Surgical procedures for sacral, trachanteric, and ischial ulcers are outlined. Complications include necrosis of skin flaps, hemotomas, infection, and wound separation.