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Considerations on gastroschisis repair.
S Ionescu1, B Andrei, S Tirlea
1Department of Pediatric Surgery, Marie S. Curie Emergency Children Hospital, Bucharest, Romania. nsionescu@yahoo.com
Chirurgia (Bucharest, Romania : 1990)
|August 21, 2013
Summary
This study presents an innovative umbilical cord patch technique for gastroschisis repair when primary closure is not feasible. This method offers excellent outcomes, is cost-effective, and reduces infection risk in infants.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Abdominal Wall Defects
Background:
- Gastroschisis repair often requires management of large abdominal wall defects.
- Previous methods for covering eviscerated bowel include skin grafts and dura mater grafts.
- Primary closure can lead to increased intra-abdominal pressure if the abdominal cavity is hypoplastic.
Purpose of the Study:
- To introduce an alternative repair method for gastroschisis in cases with disproportionate organ evisceration and a small abdominal cavity.
- To address the challenge of increased intra-abdominal pressure associated with primary closure in such scenarios.
Main Methods:
- An alternative repair method utilizing an umbilical cord patch was employed for parietal defects when primary closure was not possible.
- The umbilical cord patch creates a mesothelial surface in direct contact with the eviscerated bowel.
Main Results:
- The umbilical cord patch technique demonstrated excellent long-term results in patients.
- This method facilitates the creation of a biologically compatible surface for bowel contact.
Conclusions:
- The umbilical cord patch is an easy-to-apply and effective technique for gastroschisis repair, particularly when primary closure is not achievable.
- Using autologous umbilical cord offers advantages such as availability, reduced infection rates, and lower costs.
