title: VAC® therapy a therapeutic alternative in giant omphalocele treatment: a multicenter study.
abstract: Giant omphalocele is associated to morbidity and mortality because of the strain the reintegrated herniated mass places on the hemodynamic equilibrium and breathing functions of affected infants. Currently, care management consists in a reintegration in one time or progressive reintegration. We report here a multicenter retrospective study about alternative management by VAC® therapy for giant omphaloceles. The study included three patients (1 girl, 2 boys) presenting with giant omphaloceles, born at full term in three different University Hospitals (prenatal diagnosis, normal karyotype). VAC® therapy was implemented at different times according to the cases (at Day 11, Month 1 and Month 5 after birth). The initial pressure applied was -10 mmHg progressively increased to -50 mmHg. A middle size VAC GranuFoam Silver® Dressing was used in all cases. Wound healing occurred at Month 4 for the first case, Month 6 and Month 8 for the other two. VAC® therapy is a good alternative for the care management of giant omphaloceles with more advantages especially when using prosthetic material. We also aimed at refining the most adapted indications in these specific situations, and finally we envisioned a harmonization of care for these children.
authors.affiliation: Pediatric Surgery Unit - University Hospital of Reims, 47, Rue Cognacq-Jay, 51092 Reims Cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Binet
authors.forename: T
authors.initials: T
authors.lastname: Gelas
authors.forename: S
authors.initials: S
authors.lastname: Jochault-Ritz
authors.forename: O
authors.initials: O
authors.lastname: Noizet
authors.forename: J P
authors.initials: JP
authors.lastname: Bory
authors.forename: F
authors.initials: F
authors.lastname: Lefebvre
authors.forename: M
authors.initials: M
authors.lastname: Belouadah
authors.forename: I
authors.initials: I
authors.lastname: James-Robert
authors.forename: D
authors.initials: D
authors.lastname: Aubert
authors.forename: M A
authors.initials: MA
authors.lastname: Bouche-Pillon Persyn
authors.forename: M L
authors.initials: ML
authors.lastname: Poli-Merol
authors.forename: C
authors.initials: C
authors.lastname: François-Fiquet
mesh_terms: D005260:Female; D006554:Hernia, Umbilical; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D012189:Retrospective Studies; D014945:Wound Healing
keywords: Giant omphalocele; Pediatric surgery; Plastic surgery; VAC(®) therapy