The giant omphalocele: a new approach for a rapid and complete closure.
Giant omphaloceles are usually treated in stages. The skin is closed first and the ensuing giant ventral hernia is repaired when the patient is 1 year old or older. This attitude has many advantages, but treatment of the giant ventral hernia may be very difficult and often requires many operations. We have used a new approach to this problem in two cases. A polyamide mesh is glued over the skin of the abdominal wall, thorax, and lumbar regions. The distance between the apposed rectus muscles is then progressively decreased by repeated infolding of the polyamide mesh with running longitudinal sutures on the mesh itself. This progressively reduces the hernial content. When the rectus muscles are sufficiently approximated, a definitive procedure is carried out. In the first patient, the giant hernia was completely closed in 3 weeks and in the second patient, it was closed in 5 weeks. A third patient is presently undergoing the same treatment. This simple bedside technique does not require any antiseptic measure and may replace advantageously the use of prosthetic material in a majority of cases.
D000009:Abdominal Muscles / Q000601:surgery*; D005260:Female; D006554:Hernia, Umbilical / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D013526:Surgical Mesh; D013536:Suture Techniques; D013997:Time Factors