Reconstructive SurgeryAn Application of Keystone Perforator Island Flap for Closure of Lumbosacral Myelomeningocele DefectsPark, Hye-Sung MBBS; Morrison, Edwin MBBS; Lo, Cheng FRACS; Leong, James MS, FRACSAuthor Information From the Department of Plastic and Reconstructive Surgery, Department of Surgery, Monash Health, Monash University, Melbourne, Australia. Received March 12, 2015, and accepted for publication, after revision June 18, 2015. Conflicts of interest and sources of funding: none declared. Reprints: Hye-Sung Park, MBBS, Dandenong Hospital, Victoria, Australia. E-mail: [email protected]. Annals of Plastic Surgery: September 2016 - Volume 77 - Issue 3 - p 332-336 doi: 10.1097/SAP.0000000000000600 Buy Metrics Abstract Myelomeningocele, also known as spina bifida, is the commonest form of neural tube defect in which both meninges and spinal cord herniate through a large vertebral defect. It may be located at any spinal level; however; lumbosacral involvement is most common. After birth, the closure of spinal lesion is preferably undertaken in the first 48 hours to minimize the risk of injury and central nervous system infection. Relatively small skin defects overlying the dural repair may be directly closed. However, larger defects require reconstructive closure. Numerous methods of reconstruction have been described, such as split skin graft, local flaps or lumbosacral fasciocutaneous flaps, muscle flaps using latissimus dorsi, gluteal or paraspinous muscles, and perforator flaps namely superior gluteal artery perforators, and dorsal intercostal artery perforator flaps. At Monash Health, Victoria, we have used the keystone perforator island flaps to reconstruct lumbosacral myelomeningocele defects on 5 newborns between January 2008 and January 2014. This article evaluates the short-term and long-term outcomes of these patients who were followed up for 10 to 66 months. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.