Silo formation without suturing in gastroschisis: use of Steridrape for delayed repair.
Although primary repair is preferred for gastroschisis, this cannot be performed in many patients because of the visceroabdominal disproportion or other accompanying conditions. Several prosthetic materials are used for a silo or patch. When prosthetics are used, staged operations are necessary and infection is an inherent problem. However, these problems can be avoided by using Steridrape for a silo without suturing. The authors used the Steridrape to create a covering for two patients. The eviscerated bowel was irrigated and the abdominal wall was cleansed. A sheet of Steridrape was attached onto the abdominal wall and the herniated viscera was wrapped with it. A second sheet was applied over the first one. Antibiotics were administered and parenteral nutrition was started. The Steridrape covering was changed twice a week. In 1 week the edema subsided remarkably and in 2 weeks the bowel had an almost normal appearance except for hyperemic serosa. Primary repair was performed on the 19th hospital day in patient 1, the 14th day in patient 2. Oral feeding was started 7 days after repair in patient 1, and 22 days after repair in patient 2. Patient 2 developed aspiration pneumonia during transport. Discharge was on the 18th day after surgery in patient 1 and the 50th day in patient 2. The patients are now 18 months and 14 months old, respectively, and are doing well. Steridrape application in gastroschisis is economical, easy to perform, and is a better method to use when transporting the patient. It also facilitates drainage of purulent exudate, and allows the bowel to be inspected easily. This method has proved useful in treating two patients with gastroschisis.
Lee
S C
SC
Department of Pediatric Surgery, Seoul National University Children's Hospital, Korea.
Jung
S E
SE
Kim
W K
WK
D000009:Abdominal Muscles / Q000002:abnormalities* / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004322:Drainage; D004487:Edema / Q000628:therapy; D004750:Enteral Nutrition; D005122:Exudates and Transudates; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery / Q000628:therapy; D006801:Humans; D006940:Hyperemia / Q000628:therapy; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000628:therapy; D008297:Male; D008722:Methods; D009779:Occlusive Dressings; D010288:Parenteral Nutrition; D010351:Patient Discharge; D011015:Pneumonia, Aspiration / Q000209:etiology; D013526:Surgical Mesh; D013537:Sutures; D007507:Therapeutic Irrigation
D000900:Anti-Bacterial Agents