Sutureless vs Sutured Gastroschisis Closure: A Prospective Randomized Controlled Trial

Area of Science:

• Pediatric Surgery
• Neonatal Care
• Abdominal Wall Defects

Background:

• Gastroschisis repair traditionally involves sutured closure of the abdominal wall defect.
• Sutureless repair, utilizing secondary intention, lacks randomized outcome data.
• This study aimed to compare sutureless vs. sutured gastroschisis repair outcomes.

Purpose of the Study:

• To prospectively compare short-term outcomes of sutureless versus sutured gastroschisis repair.
• To evaluate differences in ventilation, feeding, and discharge times.
• To assess complication rates between the two repair methods.

Main Methods:

• A randomized controlled trial comparing sutureless and sutured gastroschisis repair.
• Exclusion of patients with complicated gastroschisis.
• Standardized protocols for ventilation, feeding, and dressing changes were applied.

Main Results:

• No significant difference in time to extubation between groups (p=0.061).
• Sutureless repair showed a significant increase in time to full feeds (45.1 vs. 27.8 days, p=0.031).
• Sutureless repair was associated with a longer time to discharge (49.3 vs. 31.4 days, p=0.016) and similar complication rates.

Conclusions:

• Sutureless gastroschisis repair is a safe alternative for uncomplicated cases.
• However, sutureless repair is linked to prolonged time to full feeds and discharge.
• Factors influencing discharge time include sutureless repair, feeding complications, and sepsis.