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sutureless gastroschisis

Gillian E Pet, Rebecca A Stark, John J Meehan, Patrick J Javid
INTRODUCTION: Newborns with gastroschisis have historically undergone surgical repair under general anesthesia. Our institution recently transitioned to the sutureless umbilical closure for gastroschisis. We sought to evaluate the feasibility of bedside gastroschisis repair without endotracheal intubation. METHODS: A retrospective review was performed of neonates with gastroschisis who underwent sutureless umbilical closure from 2011 to 2015. Clinical characteristics and outcomes between groups were compared...
May 2017: American Journal of Surgery
Matias Bruzoni, Joshua D Jaramillo, Jonathan L Dunlap, Claire Abrajano, Shobha W Stack, Susan R Hintz, Tina Hernandez-Boussard, Sanjeev Dutta
BACKGROUND: Sutureless gastroschisis repair involves covering the abdominal wall defect with the umbilical cord or a synthetic dressing to allow closure by secondary intention. No randomized studies have described the outcomes of this technique. Our objective was to prospectively compare short-term outcomes of sutureless vs sutured closure in a randomized fashion. STUDY DESIGN: We recruited patients who presented with gastroschisis between 2009 and 2014 and were randomized into either sutureless or sutured treatment groups...
June 2017: Journal of the American College of Surgeons
Rachel V O'Connell, Sarah K Dotters-Katz, Jeffrey A Kuller, Robert A Strauss
We performed an evidence-based review of the obstetrical management of gastroschisis. Gastroschisis is an abdominal wall defect, which has increased in frequency in recent decades. There is variation of prevalence by ethnicity and several known maternal risk factors. Herniated intestinal loops lacking a covering membrane can be identified with prenatal ultrasonography, and maternal serum α-fetoprotein level is commonly elevated. Because of the increased risk for growth restriction, amniotic fluid abnormalities, and fetal demise, antenatal testing is generally recommended...
September 2016: Obstetrical & Gynecological Survey
L G C Tullie, G M Bough, A Shalaby, E M Kiely, J I Curry, A Pierro, P De Coppi, K M K Cross
PURPOSE: To assess incidence and natural history of umbilical hernia following sutured and sutureless gastroschisis closure. METHODS: With audit approval, we undertook a retrospective clinical record review of all gastroschisis closures in our institution (2007-2013). Patient demographics, gastroschisis closure method and umbilical hernia occurrence were recorded. Data, presented as median (range), underwent appropriate statistical analysis. RESULTS: Fifty-three patients were identified, gestation 36 weeks (31-38), birth weight 2...
August 2016: Pediatric Surgery International
Patrick M Chesley, Daniel J Ledbetter, John J Meehan, Assaf P Oron, Patrick J Javid
BACKGROUND: Gastroschisis is a newborn anomaly requiring emergent surgical intervention. We review our experience with gastroschisis to examine trends in contemporary surgical management. METHODS: Infants who underwent initial surgical management of gastroschisis from 1996 to 2014 at a pediatric hospital were reviewed. Closure techniques included primary fascial repair using suture or sutureless umbilical closure, and staged repair using sutured or spring-loaded silo (SLS)...
May 2015: American Journal of Surgery
Gonca Koc, Jesse L Courtier, Jane S Kim, Douglas N Miniati, John D MacKenzie
A relatively new surgical technique allows for sutureless closure of a gastroschisis defect. Immediately after birth, a long umbilical cord stump is temporarily inverted into the abdominal cavity and later retracted and used to close the abdominal wall defect. Knowledge of this entity is important since the inverted umbilical cord simulates an intra-abdominal mass on cross-sectional imaging. While this procedure is well described in the surgical literature, the imaging features of inverted umbilical cord have yet to be reported...
January 2014: Pediatric Radiology
Augusto Zani, Elke Ruttenstock, Mark Davenport, Niyi Ade-Ajayi
AIM: To report the first European survey on the current management of gastroschisis and ascertain the degree of variability between centers. METHODS: A 10-question survey was administered at the 2011 European Paediatric Surgeons' Association (EUPSA) Congress. Questionnaires were completed by 205 delegates from 39 countries. A total of 21 responses (10%) were incomplete and voided. The remaining 184 were divided on the basis of following region of practice: Western Europe (WE, n = 102), Eastern Europe (EE, n = 59), and non-European countries (n = 23)...
February 2013: European Journal of Pediatric Surgery
Wilson W Choi, Craig A McBride, Chris Bourke, Peter Borzi, Kelvin Choo, Rosslyn Walker, Tuan Nguyen, Mark Davies, Tim Donovan, David Cartwright, Roy M Kimble
BACKGROUND: A sutureless ward reduction (SWR) protocol was implemented in the neonatal intensive care unit of a tertiary level hospital in 1999. Although the short-term outcomes associated with SWR have been documented, the long-term outcomes are unknown. METHODS: Retrospective data were collected from the medical records of all neonates with gastroschisis from September 1999 to December 2010. Data on their growth and development and the prevalence of any health problems were collected...
August 2012: Journal of Pediatric Surgery
Kristine Clodfelter Orion, Michael Krein, Junlin Liao, Aimen F Shaaban, Graeme J Pitcher, Joel Shilyansky
BACKGROUND: Gastroschisis is a congenital abdominal wall defect in which the intestines develop outside the abdomen and are exposed to amniotic fluid. When the defect is small, lymphatic, venous, and intestinal obstruction may occur and contribute to the formation of intestinal edema, atresia, ischemia, and a thick inflammatory peel. Treatment requires early coverage of abdominal contents either by primary closure or by the placement of temporary Silastic silo followed by abdominal wall closure...
August 2011: Surgery
Mizuho Machida, Shigeru Takamizawa, Katsumi Yoshizawa
A sutureless gastroschisis closure provides a cosmetically appealing outcome. The umbilical cord is usually used as a covering material in a sutureless closure because it is a native tissue. However, during the staged closure with a silo placement, special attention is required to keep the umbilical cord moist. The authors report a simple technique to preserve the feasibility of the umbilical cord as a biologic dressing during the silo placement in staged gastroschisis closures.
January 2011: Pediatric Surgery International
Jonathan Riboh, Claire T Abrajano, Karen Garber, Gary Hartman, Marilyn A Butler, Craig T Albanese, Karl G Sylvester, Sanjeev Dutta
INTRODUCTION: A new technique of gastroschisis closure in which the defect is covered with sterile dressings and allowed to granulate without suture repair was first described in 2004. Little is known about the outcomes of this technique. This study evaluated short-term outcomes from the largest series of sutureless gastroschisis closures. METHODS AND PATIENTS: A retrospective case control study of 26 patients undergoing sutureless closure between 2006 and 2008 was compared to a historical control group of 20 patients with suture closure of the abdominal fascia between 2004 and 2006...
October 2009: Journal of Pediatric Surgery
Yuki Ogasawara, Tadaharu Okazaki, Yoshifumi Kato, Geoffrey J Lane, Atsuyuki Yamataka
PURPOSE: We report our experience of using a commercial wound protector and retractor system to allow spontaneous sutureless closure of the abdominal wall defect in gastroschisis. METHODS: Following birth, eviscerated bowel is wrapped with polyethylene wrap, the umbilical cord is deliberately left long and kept moist, and the patient stabilized and transferred to the operating room. Then the Applied Alexis wound protector and retractor system (Applied Medical Resources Corp, USA) was used for reducing eviscerated bowel...
November 2009: Pediatric Surgery International
B A Hubbard, A Pimpalwar
No abstract text is available yet for this article.
April 2009: European Journal of Pediatric Surgery
Robert L Weinsheimer, Natalie L Yanchar, Sarah B Bouchard, Peter K Kim, Jean-Martin Laberge, Erik D Skarsgard, S K Lee, Douglas McMillan, Peter von Dadelszen
BACKGROUND/PURPOSE: Management of gastroschisis varies. This study aims to determine which aspects of practice influence outcomes. METHODS: All cases of simple gastroschisis (N = 99) in the Canadian Pediatric Surgery Network database were analyzed looking at methods of preoperative bowel protection, timing of closure, and closure techniques; and outcome measures included time to onset of enteral feeds, duration of parenteral nutrition (PN), and length of stay (LOS)...
May 2008: Journal of Pediatric Surgery
Anthony Sandler, John Lawrence, John Meehan, Laura Phearman, Robert Soper
BACKGROUND/PURPOSE: Several techniques are described for closure of the gastroschisis abdominal wall defect. The authors describe a technique that allows for spontaneous closure that is simple, cosmetically appealing, and minimizes intraabdominal pressure after bowel reduction. METHODS: Under either general anesthetic or analgesia with sedation, the gastroschisis bowel is decompressed, and the bowel is primarily reduced. The gastroschisis defect is covered with the umbilical cord tailored to fit the opening, and 2 Tegaderm (3M Healthcare, MN) dressings reinforce the defect ("plastic closure")...
May 2004: Journal of Pediatric Surgery
Frederick Alexander, Dadvand Babak, Marilyn Goske
Multiple intestinal atresia presents a difficult technical problem because of extreme loss of intestinal length, disparity of residual bowel wall size, and discontinuity of multiple short intestinal segments. The authors report on a 3,000-g infant with gastroschisis complicated by intrauterine volvulus and multiple intestinal atresias who was treated successfully with intraluminal stenting and sutureless anastomoses. A total of 25 cm of small bowel was salvaged including 13 segments each measuring 1 to 8 cm in length...
November 2002: Journal of Pediatric Surgery
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