Staged compressive dressing method for primary giant omphalocele repair: a low-cost and successful strategy
Ali Ekber Hakalmaz1, Rahşan Özcan2, Ayşe Karagöz1
1Department of Pediatric Surgery, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Cerrahpasa, Fatih, 34096, Istanbul, Turkey.
Purpose:
In giant omphalocele cases, small abdominal cavity leads to high intraabdominal pressure during closure, making repair challenging. This study aimed to evaluate our staged compressive dressing technique and its outcomes.
Methods:
Eighteen giant omphalocele cases treated with staged compressive dressing/primary closure between 2014 and 2024 were retrospectively reviewed. All cases received compressive dressing every other day with wet sterile gauze and transparent adhesive surgical drapes from the first postnatal day until surgery to reduce intra-sac organs. Primary closure was performed after organ reduction.
Results:
Eighteen cases (Female/Male: 10/8) were included. Mean gestational age was 36.8 ± 1.7 weeks, birth weight 2988 ± 603 g. Major cardiac anomaly was present in 16.7% and liver herniation in 83.3%. Mean defect diameter was 6.0 ± 1.2 cm. Mean time to surgery was 6.4 ± 5.1 days. Primary repair was successfully performed in all cases (100%). Operation was delayed in patients with cardiac anomaly (13.0 ± 9.2 vs. 5.3 ± 3.4 days, p = 0.012). Seven patients (38.9%) had prolonged hospitalization (> 20 days). One patient with cardiac anomaly died postoperatively. Mean hospital stay was 22.2 ± 11.0 days .
Conclusion:
In this single-center retrospective study, the staged compressive dressing technique appeared to be a feasible, simple, and potentially cost-effective method for giant omphalocele management. While we achieved primary closure in all cases without prosthetic materials, these findings require validation through larger multicenter studies and comparative trials before definitive conclusions can be drawn about superiority over alternative methods.
