Negative pressure wound therapy facilitates closure of large congenital abdominal wall defects

The degree of viscero-abdominal disproportion often makes single-stage reduction difficult in large abdominal wall defects, without risking respiratory or hemodynamic compromise. As a consequence, clinicians have adopted a number of different methods to control these defects. Repair may be in the neonatal period, or later in life. Delayed repairs require epithelialization of the gastroschisis or omphalocele. Definitive repair may be in single or multiple stages. This paper describes four children in whom negative pressure wound therapy (NPWT) was used to facilitate closure of these complex defects.