title: The outcome of newborns with abdominal wall defects according to the method of abdominal closure: the experience of a single center.
abstract: Recent reports suggest that the technique of abdominal closure in neonates with anterior abdominal wall defects (AWD) correlates with the outcome. The aim of this study is to analyze factors related to mortality and morbidity, according to the technique of abdominal closure of these neonates. Retrospective analysis of charts from 76 consecutive neonates with AWD treated in a single institution. They were divided according to the type of abdominal wall closure: group I: primary closure, group II: silo followed by primary closure and group III: silo followed by polypropylene mesh. Outcome was analyzed separately for neonates with gastroschisis and omphalocele. There were 13 deaths (17.1%). Mortality for neonates with isolated defects was 9.6%. Mortality rate was similar in all groups for either neonates with gastroschisis or omphalocele. Postoperative complications were not significantly different among groups except for a prolonged time of hospitalization in group III. Mortality rate is not correlated with the type of abdominal closure. Neonates with primary closure or with other methods of abdominal wall closure had similar rate of postoperative complications. Neonates with mesh closure of the abdomen have prolonged hospitalization. The use of a polypropylene mesh is a good alternative for neonates whose primary closure or closure after silo placement is not possible.
authors.affiliation: Service of Pediatric Surgery, Instituto da Criança Prof. Pedro de Alcantara, University of São Paulo Medical School, Sao Paulo, SP, Brazil.
authors.forename: João Gilberto
authors.initials: JG
authors.lastname: Maksoud-Filho
authors.forename: Uenis
authors.initials: U
authors.lastname: Tannuri
authors.forename: Marcos Marques
authors.initials: MM
authors.lastname: da Silva
authors.forename: João Gilberto
authors.initials: JG
authors.lastname: Maksoud
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D005260:Female; D020139:Gastroschisis / Q000601:surgery*; D006554:Hernia, Umbilical / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013526:Surgical Mesh; D016896:Treatment Outcome