Slovenská chirurgia 3-4e/2024
Current options for covering the open neural tube defect in fetal surgery
Open spina bifida (OSB) is a devastating congenital malformation of the central nervous system associated with significant morbidity. In the past, only postnatal surgical or palliative treatment were possible. Nowadays, prenatal surgical treatment is coming to the fore. The favorable effect of the prenatal operation lies in the early covering of the neural tube defect. The goal is to reduce the leakage of cerebrospinal fluid through the defect, thus reducing the probability of the need for shunt implantation after birth, preventing the occurrence of Chiari II malformation, tethered spinal cord syndrome and syringomyelia. However, in 20–30% of fetuses, the defect is too large for primary skin closure. Various techniques and materials are applied in current practice to manage large defects (1, 2, 3, 4). The purpose of this article is to introduce the readers to the current options for replacement defect coverage. The article describes the results of 6 studies in which different techniques and biomaterials were used.
Keywords: fetal surgery for meningomyelocele, primary skin defect closure, patch-based skin defect closure
