Split thickness skin grafting plus dural closure in management of myelomeningocele

This study was designed to evaluate post operative and long term follow up wound healing after using two methods of repair [direct closure or covering by split thickness skin grafts. Long term follow up revealed a higher incidence of chronic skin ulceration the split-thickness skin graft group as compared with the primary closure group. All skin breakdowns appeared in the presence of C.S.F. leakage and or the presence of Gibbus deformity. A thoracic or thoracolumbar myelomeningocele repair with split thickness skin graft was more likely to be complicated by skin problems than the defects in the lumbar lumbosacral or sacral region. This relationship was secondary to the frequency of gibbus deformity in the more cephalad defects than caudal defects

Temporary subcutaneous implantation of bone flaps after craniectomy for brain aedema

Craniectomy may be carried out as a sort of decompression in sever unilateral brain oedema. Bone flaps if not infected or invaded by a malignant growth can be conserved as autogenous bone is the best material for cranioplasty. Due to the lack of freezing facility for conservation, we have implanted 7 flaps under the subcutaneous layer of the patient's,thighs.All did not have any significant complications and the previous craniectomy bone was used successfully for cranioplasty in six cases as our patient died after implantation. 3 months postcranioplasty follow up showed no infection among the six cases