title: Staged gastroschisis closure using Alexis wound retractor: first experiences.
abstract: BACKGROUND
  The aim of this study is to analyze the effectiveness of an Alexis wound retractor (AWR) device for staged gastroschisis closures.
  
  
  METHODS
  AWR device was used to cover unreduced viscera of a gastroschisis when primary abdominal wall closure was not convenient. The eviscerated organs were covered with one of the two spring-loaded rings of the AWR inserted underneath the abdominal wall. Gradual reduction was guaranteed through careful traction on the external ring. We retrospectively analyzed the prenatal, post-natal and operative data of the first patients treated with AWR and report their post-operative outcomes.
  
  
  RESULTS
  The AWR device was used for staged closure in eight cases. Complete reduction and fascial closure were performed at a median of 3.5 ± 1.6 days. Ventilatory support was necessary for 4.0 ± 3 days and full parenteral feeds for 7.5 ± 6.1 days after fascial closure. Median full enteral feeding was observed at 18 ± 12.5 days after closure allowing discharge in a median period of 30.5 ± 15.6 days after closure.
  
  
  CONCLUSIONS
  The AWR device is not only a safe and efficient silo for a progressive reduction of severe gastroschisis, but also an interesting tool for continuous stretching leading to an increase of the peritoneal cavity volume, enhancing the equalizing of the viscero-abdominal disproportion.
authors: Department of Pediatric Surgery, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, 67098, France, gomes.cindy@chl.lu.
authors: Cindy
authors: C
authors: Gomes Ferreira
authors: Isabelle
authors: I
authors: Lacreuse
authors: Dorothée
authors: D
authors: Geslin
authors: Françoise
authors: F
authors: Schmitt
authors: Anne
authors: A
authors: Schneider
authors: Guillaume
authors: G
authors: Podevin
authors: François
authors: F
authors: Becmeur
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D005260:Female; D020139:Gastroschisis / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D019736:Prostheses and Implants; D012189:Retrospective Studies; D016896:Treatment Outcome