Negative pressure wound therapy for initial management of giant omphalocele.
Am J Surg 2015;
211:605-9. [PMID:
26778271 DOI:
10.1016/j.amjsurg.2015.11.009]
[Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 11/25/2015] [Accepted: 11/30/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND
Current treatment of giant omphalocele includes "paint and wait" or placement of mesh or silo. These methods are associated with high complication rates. We propose negative pressure wound therapy as an alternative.
METHODS
Patients born between 2009 and 2014 with giant omphalocele were included. Outcomes analyzed were duration of therapy, time to full enteral feeds, treatment related complications, wound surface area over time, type, and time to definitive closure.
RESULTS
Eight patients were reviewed. The median duration of therapy was 68 days. Median time to full enteral feeds was 19 days. There were no treatment discontinuations or complications including sac ruptures, wound infections, or fistulas. Wound contraction stopped at 2 months or around 7 cm(2). All surviving patients underwent definitive closure.
CONCLUSIONS
Negative pressure wound therapy is a safe and effective treatment for giant omphalocele that allows feeding, has a low complication rate, and is completed in 2 months.
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