Umbilical cord as temporary coverage in gastroschisis
| Autor: | R. Werbeck, J. Koltai |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Cord medicine.medical_treatment Umbilical cord Surgical Flaps Fasciotomy Umbilical Cord Gastro medicine Humans Gastroschisis business.industry Abdominal wall defect Infant Newborn Chylothorax Fascia medicine.disease Surgery medicine.anatomical_structure Anesthesia Pediatrics Perinatology and Child Health Female business |
| Zdroj: | European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie. 21(5) |
| ISSN: | 1439-359X |
| Popis: | Introduction: Although the early defi nitive closure of gastroschisis is possible in many cases, there is an ongoing discussion about the advan- tages of staged reduction. Diff erent strategies and materials have been described to wrap the bowel for protection and reduce heat and fl uid loss. The variety of devices ranges from pros- thetic patches to biomaterials. We present use of the umbilical cord for temporary coverage in primarily irreducible gastroschisis. Method: After revision and reduction of as much gut as possible under constant monitoring of the bladder pressure, the remaining eviscer- ated intestine is covered by the longitudinally split umbilical cord. Over the following days the continued reduction of the bowel relies on grav- ity, assisted by progressive compression by the shrinking umbilical cord tissue. At 10 days after performing the umbilical cord fl ap, it is possible to close the fascia without complications using gentle pressure. Results: Since 1991 we have used this umbili- cal cord fl ap for staged reduction in 17 infants (10 females, 7 males) with giant gastroschisis. There were no complications related to use of the umbilical cord fl ap, no infections or NEC epi- sodes, and no mortality. Length of hospital stay was 5 weeks on average. In 3 patients the course was complicated by associated defects or an underlying malformation. Conclusion: Our experience confi rms the advantage of a staged reduction in giant gastro- schisis. The use of autogenic material such as the umbilical cord has advantages such as low infec- tion rates and easy availability. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|