Document Detail

Outcomes of sutureless gastroschisis closure.
MedLine Citation:
PMID:  19853753     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: A new technique of gastroschisis closure in which the defect is covered with sterile dressings and allowed to granulate without suture repair was first described in 2004. Little is known about the outcomes of this technique. This study evaluated short-term outcomes from the largest series of sutureless gastroschisis closures. METHODS AND PATIENTS: A retrospective case control study of 26 patients undergoing sutureless closure between 2006 and 2008 was compared to a historical control group of 20 patients with suture closure of the abdominal fascia between 2004 and 2006. Four major outcomes were assessed: (1) time spent on ventilator, (2) time to initiating enteral feeds, (3) time to discharge from the neonatal intensive care unit, and (4) rate of complications. RESULTS: In multivariate analysis, sutureless closure of gastroschisis defects independently reduced the time to extubation as compared to traditional closure (5.0 vs 12.1 days, P = .025). There was no difference in time to full enteral feeds (16.8 vs 21.4 days, P = .15) or time to discharge (34.8 vs 49.7 days, P = .22) with sutureless closure. The need for silo reduction independently increased the time to extubation (odds ratio, 4.2; P = .002) and time to enteral feeds (odds ratio, 5.2; P < .001). Small umbilical hernias were seen in all patients. CONCLUSION: Sutureless closure of uncomplicated gastroschisis is a safe technique that reduces length of intubation and does not significantly alter the time required to reach full enteral feeds or hospital discharge.
Jonathan Riboh; Claire T Abrajano; Karen Garber; Gary Hartman; Marilyn A Butler; Craig T Albanese; Karl G Sylvester; Sanjeev Dutta
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  44     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-26     Completed Date:  2009-12-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1947-51     Citation Subset:  IM    
Division of Pediatric Surgery, Lucile Packard Children's Hospital, Stanford University Medical Center, Stanford, CA 94305-5733, USA.
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MeSH Terms
Abdominal Wall / surgery*
Case-Control Studies
Enteral Nutrition / statistics & numerical data
Fascia / surgery
Gastroschisis / surgery*
Hernia, Umbilical / surgery
Length of Stay / statistics & numerical data
Occlusive Dressings
Patient Discharge / statistics & numerical data
Postoperative Care / methods,  statistics & numerical data
Reconstructive Surgical Procedures / methods
Retrospective Studies
Suture Techniques
Time Factors
Treatment Outcome
Umbilicus / transplantation
Wound Healing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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