title: Visceral coverage with absorbable mesh followed by split-thickness skin graft in the treatment of ruptured giant omphalocele.
abstract: We report a case of ruptured giant omphalocele in whom herniated organs were successfully covered by an absorbable mesh and a subsequent skin graft. A 2,200 g male baby was born at 35 weeks of gestation. An abdominal wall abnormality was detected by prenatal ultrasound at 21 weeks of gestation. At birth, the entire liver, stomach, and small and large bowel had herniated from the defect of the abdominal wall. The thorax and abdomen were highly underdeveloped, and attempts to reduce the organs into the abdomen were unsuccessful due to the extremely small abdominal cavity and associated pulmonary hypoplasia. To protect the herniated organs and prevent abdominal infections, the organs were covered by a polyglycan mesh and subsequently a meshed split-thickness skin graft. Ten weeks later, it was confirmed that the organs were completely covered by epithelialized tissue. However, the patient suffered from frequent respiratory infections and finally died of respiratory insufficiency. Based on the experience of the patient, we conclude that coverage of the herniated organs with an absorbable mesh and a skin graft is a recommendable treatment in ruptured giant omphalocele.
authors.affiliation: Department of Pediatric Surgery, Dokkyo Medical University Koshigaya Hospital, 2-1-50, Minami-Koshigaya, Koshigaya, Saitama, 343-8555, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Yamagishi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ishimaru
authors.forename: Hajime
authors.initials: H
authors.lastname: Takayasu
authors.forename: Yushi
authors.initials: Y
authors.lastname: Otani
authors.forename: Kazunori
authors.initials: K
authors.lastname: Tahara
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hatanaka
authors.forename: Akito
authors.initials: A
authors.lastname: Hamajima
authors.forename: Akira
authors.initials: A
authors.lastname: Hasumi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ikeda
mesh_terms: D017809:Fatal Outcome; D006554:Hernia, Umbilical / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012421:Rupture; D016038:Skin Transplantation; D013526:Surgical Mesh