Abdominal wall closure with a silastic patch after repair of congenital diaphragmatic hernia.
OBJECTIVE
Newborns with congenital diaphragmatic hernia (CDH) have a high risk of mortality, ranging from 50% to 70%. Tensioned closure of the narrowed abdominal cavity is detrimental.


METHODS
Twelve high-risk newborns underwent operation for CDH. To achieve tension-free closure of the abdominal wall, a Silastic patch was used. The Silastic patch was sutured intermittently to the edges of the abdominal wall fascia with absorbable sutures and left open to the air. The skin was not closed above the Silastic patch, which was lubricated with 1% gentamicin sulfate ointment.


RESULTS
Eleven patients (91.6%) survived. No local or systemic septic complication occurred. The abdominal wall was gradually closed, and total closure was achieved within 4 to 6 weeks (mean, 4.9 weeks).


CONCLUSIONS
Because of the high survival rate and the complication-free rapid healing of the abdominal wall, the technique can be used in any case of CHD in which tension-free closure of the abdominal wall cannot be achieved by other methods.
Department of Surgery B, Wolfson Medical Center, Holon, Israel.
Shlomo
S
Kyzer
Lea
L
Sirota
Chaim
C
Chaimoff
D000009:Abdominal Muscles / Q000601:surgery*; D004129:Dimethylpolysiloxanes; D005260:Female; D006548:Hernia, Diaphragmatic / Q000601:surgery*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012828:Silicones; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon