Elastic bandaging facilitates primary closure of large ventral hernias due to giant omphaloceles.
Large ventral hernias (VH) following conservative treatment of a giant omphalocele are a major challenge for pediatric surgeons. Although primary closure is accepted as the ideal procedure, these defects often require multi-staged operations, prosthetic support, and postoperative mechanical ventilation. Between 1990 and 2000, 34 patients with omphaloceles were admitted to our unit and 6 of them (17.6%) who had giant omphaloceles were treated conservatively. In the same period, a 5-year-old girl was admitted with a huge VH following application of subcutaneous tissue expanders in another center. In these 7 patients (6 girls, 1 boy, average age 20 months) we used preoperative elastic bandaging for facilitating primary closure. In all cases primary closure was successful following 3 to 6 weeks of bandaging. We did not use prosthetic material or postoperative mechanical ventilation in any case. Follow-up periods ranged from 2 to 10 years, and there were no recurrences or other problems. Out limited experience reveals that preoperative elastic bandaging is a safe and effective procedure for facilitating primary closure of the large VHs.
Sander
S
S
SSK Bakirköy Maternity and Children's Hospital, Department of Pediatric Surgery, Istanbul, Turkey.
Eliçevik
M
M
Unal
M
M
D001458:Bandages; D002648:Child; D005260:Female; D006554:Hernia, Umbilical / Q000150:complications*; D006555:Hernia, Ventral / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies