| Treatment of defects of the anterior abdominal wall in newborns. | |
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MedLine Citation:
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PMID: 6645625 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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L A Smith; R L Telander; D R Cooney; B Dawson; F Kleinberg; B Kaufman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Mayo Clinic proceedings. Mayo Clinic Volume: 58 ISSN: 0025-6196 ISO Abbreviation: Mayo Clin. Proc. Publication Date: 1983 Dec |
Date Detail:
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Created Date: 1984-01-26 Completed Date: 1984-01-26 Revised Date: 2007-10-29 |
Medline Journal Info:
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Nlm Unique ID: 0405543 Medline TA: Mayo Clin Proc Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 797-801 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Critical Care Female Hernia, Umbilical / surgery* Hernia, Ventral / surgery* Humans Infant, Newborn Infant, Premature, Diseases / surgery Male Methods Postoperative Complications Prostheses and Implants* Retrospective Studies Silicone Elastomers* Surgical Mesh |
| Chemical | |
Reg. No./Substance:
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0/Silicone Elastomers |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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