The 'gentle touch' technique in the treatment of gastroschisis.
OBJECTIVE
The aim of this study was to assess the effectiveness of gravity reduction of the intestines in newborns with gastroschisis.


METHODS
Throughout the calendar year 2001, all newborns with gastroschisis were prospectively treated by means of an established clinical pathway protocol. Silon insertion and all subsequent therapies were performed in the neonatal intensive care unit (NICU) No physical compression of the bowel nor stretching of the abdominal wall was done, and bowel reduction was entirely passive, accomplished by the force of gravity. Demographic data along with time to abdominal wall closure, ileus resolution, and cessation of total parenteral nutrition (TPN) all were recorded.


RESULTS
Sixteen babies were treated using the established pathway without prenatal selection or postnatal rejection. There were 10 boys and 6 girls. The mean maternal age was 18.5 years. Seventy-five percent of the mothers were Hispanics. Mean time to Silon removal was 5.5 days, initiation of enteric feeding was 16 days and TPN cessation 23 days. There were no significant complications in this group nor was there any mortality.


CONCLUSIONS
Gravity reduction of the intestines in babies with gastroschisis is most gentle and effective. Blood flow compromise, mechanical injuries of the exposed bowel, or abdominal compartment syndrome thus were averted. The outcome analysis favorably compares this method with reported series.
Jona
Juda Z
JZ
Evanston Northwestern Healthcare, Evanston, IL 60201, USA.
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002985:Clinical Protocols; D003664:Decompression; D005260:Female; D020139:Gastroschisis / Q000628:therapy*; D006112:Gravitation; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D008297:Male; D010289:Parenteral Nutrition, Total; D011446:Prospective Studies; D012121:Respiration, Artificial
D000900:Anti-Bacterial Agents