Gastroschisis: primary closure using umbilical cord strengthened by a polypropylene mesh.
OBJECTIVE
We present a new method of repairing gastroschisis, where the disproportion between the size of the eviscerated intestine and the hypoplastic abdominal cavity could dangerously elevate abdominal pressure if primary closure of the abdominal wall is attempted.


METHODS
We used umbilical cord graft strengthened by a polypropylene mesh to achieve definitive closure of the abdominal wall in a single operation.


RESULTS
This technique provides a mesothelial surface in contact with the intestines, strengthened by a fibrous reaction that prevents future herniation. Five-year follow-up in four patients showed no umbilical hernias and overall excellent results.


CONCLUSIONS
The technique described is useful and easily applicable in children with abdominal wall defects when primary anatomic closure is not feasible. It also prevents future herniation through the anatomical defect of the abdominal wall.
Hernández Siverio
Norberto
N
Department of Paediatric Surgery, Hospital Universitario de Canarias, Spain.
M López-Tomassetti Fernández
Eudaldo
E
Mario Troyano Luque
Juan
J
D020139:Gastroschisis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D009779:Occlusive Dressings; D020959:Polyethylene; D014470:Umbilical Cord / Q000637:transplantation*
D020959:Polyethylene