JPRAS Open 21 (2019) 75–85 Contents lists available at ScienceDirect JPRAS Open journal homepage: www.elsevier.com/locate/jpra Experience with various reconstructive techniques for meningomyelocele defect closure in India Mukesh Kumar Sharma, Naveen Kumar ∗ , Manoj K Jha, Umesh N, R.K. Srivastava, Sameek Bhattacharya Department of Burns, Plastic & Reconstructive Surgery, PGIMER & Dr. R.M.L Hospital, New Delhi 110001, India a r t i c l e i n f o Article history: Received 12 April 2019 Accepted 4 July 2019 Available online 13 July 2019 Keywords: Myelomeningocele Closure Flap Limberg Rotation Transposition a b s t r a c t Background: The estimated incidence of spina bifida is 1–2 cases per 1000 population. In earlier literature, the global prevalence of meningomyelocele (MMC) is reported as 0.8–1.0 per 1000 live births. This retrospective study analyses the outcome of various surgical procedures performed for the closure of MMC defects. Method: A total of 22 patients with MMC defects who underwent repair at our institute from July 2016 to August 2018 were included in the study. A retrospective review of all the cases operated was completed to analyse patient demography including defect size, de- fect location, surgical procedures, complications and the final out- come. Results: Out of 22 cases, wherein the neurosurgery department sought help from the plastic surgery department, 11 defects were closed using the Limberg flap technique, 4 defects were closed with either primary closure or the double flap rotation flaps, one defect was closed using the triple rotation flap and 2 defects were closed using the local transposition flap cover technique. Complications were noted in only three cases. One patient had a local wound in- fection, while in two other cases, wound dehiscence was observed. All 3 cases were managed conservatively. On average, it takes ap- proximately 70 days in India to close such defects. Abbreviations: MMC, myelomeningocele; NTD, Neutral tube defect. ∗ Corresponding author. E-mail addresses: drnaveenvmmc@gmail.com, pixelfinance2000@gmail.com (N. Kumar), drmanojjha@live.com (M.K. Jha). https://doi.org/10.1016/j.jpra.2019.07.001 2352-5878/© 2019 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY-NC-ND license. (http://creativecommons.org/licenses/by-nc-nd/4.0/)