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Team Approach: Guideline-Based Management of Skin Injury in Individuals with Myelomeningocele

Bradko, Viachaslau, MD1,2; Hill, Jaclyn, MD1,2; Castillo, Heidi, MD3; Castillo, Jonathan, MD, MPH3

doi: 10.2106/JBJS.RVW.18.00062
Team Approach Review Articles

  • » As many as 100,000 people in the United States live with myelomeningocele.
  • » Due to recent advancement in treatment, about 75% of children with myelomeningocele reach adulthood. Up to 77% of patients with spina bifida report skin-breakdown issues annually.
  • » The management of patients who have myelomeningocele requires a multidisciplinary approach that should begin early in life and should aid in transitions through health-care settings across the lifespan. Education on the prevention of skin injury must be repetitive, frequent, culturally appropriate, and ongoing.
  • » The development of a team approach to evidence-based prevention, education, and treatment is imperative, with the goal of reducing skin breakdown and increasing self-management among individuals with myelomeningocele.

1Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas

2Division of Orthopedic and Scoliosis Surgery, Texas Children’s Hospital, Houston, Texas

3Developmental Pediatrics, Department of Pediatrics, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas

E-mail address for V. Bradko:

Investigation performed at Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas

Disclosure: No external funds were received in support of the present study. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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