Document Detail

Treatment of defects of the anterior abdominal wall in newborns.
MedLine Citation:
PMID:  6645625     Owner:  NLM     Status:  MEDLINE    
Primary closure of an omphalocele or gastroschisis may cause respiratory compromise in the neonate. Some authors recommend primary closure of the defect with prolonged respiratory support because of dissatisfaction with staged visceral reduction and use of a Silastic pouch. Our experience with use of a Silastic pouch from 1975 to 1982 was reviewed. Twenty-three newborns with major defects of the abdominal wall (14 omphaloceles and 9 gastroschisis anomalies) were surgically treated, and only one death occurred. The mean birth weight of the infants was 2,927 g; nine of them were premature. Seven infants had major associated anomalies. The goal of the surgical procedure was closure of the abdominal wall without compromise of the cardiorespiratory status. During the operation, muscle relaxants were avoided and the infants breathed spontaneously. If progressive visceral reduction caused tachypnea (rate of more than 70/min) or hemodynamic instability, a Silastic pouch was constructed. Ten patients were treated with primary fascial closure, and 13 were treated with a Silastic prosthesis. The neonates with the prostheses required three to eight reductions, and the prostheses were in place for 4 to 22 days. No patient had wound dehiscence, wound infection, or an intestinal fistula. The one death occurred in an infant with trisomy 18 syndrome and multiple anomalies. Thus, the Silastic pouch was effective when the defect could not be closed primarily without respiratory compromise.
L A Smith; R L Telander; D R Cooney; B Dawson; F Kleinberg; B Kaufman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Mayo Clinic proceedings     Volume:  58     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  1983 Dec 
Date Detail:
Created Date:  1984-01-26     Completed Date:  1984-01-26     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  797-801     Citation Subset:  AIM; IM    
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MeSH Terms
Critical Care
Hernia, Umbilical / surgery*
Hernia, Ventral / surgery*
Infant, Newborn
Infant, Premature, Diseases / surgery
Postoperative Complications
Prostheses and Implants*
Retrospective Studies
Silicone Elastomers*
Surgical Mesh
Reg. No./Substance:
0/Silicone Elastomers

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

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