Tissue expansion for the delayed closure of large myelomeningoceles.

OBJECT: Numerous techniques for the soft-tissue closure of large myelomeningoceles have been described. When patients present for delayed repair beyond the neonatal period, the indications for surgery are both different and less immediate. METHODS: Six patients between 6 weeks and 3.5 years of age with defects ranging from 27 to 49 cm2 (mean 37 cm2) were referred to the authors' institution and were successfully treated by direct skin closure after tissue expansion. CONCLUSIONS: In this paper the authors describe the technique and advantages of expansion compared with those of locoregional flaps in this subgroup of patients with myelomeningoceles.