| Variability in Gastroschisis Management: A Survey of North American Pediatric Surgery Training Programs. | |
| | |
MedLine Citation:
|
PMID: 21737095 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: The optimal surgical management of gastroschisis has yet to be determined. We sought to define the practice patterns in the management of gastroschisis, and to ascertain the degree of variability among and within pediatric surgical training programs. MATERIALS AND METHODS: An electronic survey was sent to all second-year residents in ACGME-accredited pediatric surgery programs in the United States and Canada. The questionnaire evaluated operative strategies, pain control, complications, and adherence to institutional protocols. RESULTS: Of the 38 pediatric surgical training programs, 27 second-year residents (71%) completed the survey. An institutional protocol was utilized in only one program, and 70% reported treatment variability among faculty. Attempted primary closure was the treatment of choice in 76% of centers, and routine silo placement at 24%. The location for routine silo placement was in the neonatal intensive care unit (77%), operating room (22%), and delivery room (1%). General anesthesia was used for all primary closures, while silos were placed using intravenous sedation at 36% of centers. The most frequent silo-related complication was dislodgement, reported by 80%. Other preformed silo complications included the inability to achieve primary fascial closure (27%) and intestinal injury (27%). When entering clinical practice, 74% of trainees stated that they would first attempt primary closure, while 22% favored routine placement of a preformed silo. CONCLUSIONS: Protocol-driven care of infants with gastroschisis is rare in pediatric surgery training centers, leading to great variability in care between institutions, as well as among faculty within single programs. Data-driven protocols may improve care of infants with gastroschisis. |
| | |
Authors:
|
Jennifer H Aldrink; Donna A Caniano; Benedict C Nwomeh |
Related Documents
:
|
16525065 - Core curriculum for training in behavioral neurology & neuropsychiatry. 9369875 - Sun protection counseling by pediatricians. 19036735 - Can an advanced laparoscopic fellowship program be established without compromising the... 20921355 - Longitudinal assessment of the timing of career choice among pediatric residents. 15156085 - Musculoskeletal injuries associated with selected university staff and faculty in an of... 22477075 - Verbal responses to past events: intraverbal relations, or tacts to private events? |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-6-12 |
Journal Detail:
|
Title: The Journal of surgical research Volume: - ISSN: 1095-8673 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
|
Created Date: 2011-7-8 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0376340 Medline TA: J Surg Res Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Surgery, Division of Pediatric Surgery, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, Ohio. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Nitric Oxide Increases Lysine 48-Linked Ubiquitination Following Arterial Injury.
Next Document: Alcohol is Associated with a Lower Pneumonia Rate After Traumatic Brain Injury.