title: Non-operative management of giant omphalocele with topical povidone-iodine and powdered antibiotic combination: early experience from a tertiary centre.
abstract: OBJECTIVE
  The aim of the study was to evaluate topical povidone-iodine and topical powdered antibiotic combination (Polymyxin, Bacitracin and Neomycin) in initial non-operative management with delayed closure of the defect of giant omphaloceles.
  
  
  METHODS
  A prospective study was conducted between July 2010 and June 2013 including all neonates with giant omphalocele without signs of intestinal obstruction. All cases were managed by daily application of povidone-iodine (5% solution) followed by spraying topical powdered antibiotic combination to promote eschar formation and eventual epithelialisation. Record was made of sex, associated anomalies, length of stay, and thyroid function tests.
  
  
  RESULTS
  Twenty-four neonates with giant omphaloceles were treated with topical povidone-iodine and topical powdered antibiotic combination. No sac ruptures were observed in our series. All patients had a normal thyroid function test at presentation and after 10 days of initiation of treatment. Six patients have undergone delayed repair.
  
  
  CONCLUSIONS
  Topical povidone-iodine and powdered antibiotic combination promotes more rapid escharification and epithelialisation of the omphalocele than povidone-iodine alone. We also hypothesise that combination minimises the chances of hypothyroidism associated with use of povidone-iodine alone.
authors: Department of Paediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India, sunny.imsbhu@gmail.com.
authors: Vaibhav
authors: V
authors: Pandey
authors: A N
authors: AN
authors: Gangopadhyay
authors: D K
authors: DK
authors: Gupta
authors: S P
authors: SP
authors: Sharma
authors: Vijayendar
authors: V
authors: Kumar
mesh_terms: D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006554:Hernia, Umbilical / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011208:Powders; D011446:Prospective Studies; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D011208:Powders; D011206:Povidone-Iodine