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By Alejandro Peñarrieta Daher Pediatric Surgeon / Neonatal Surgeon
Steven L Raymond, Cynthia D Downard, Shawn D St Peter, Joanne Baerg, Faisal G Qureshi, Steven W Bruch, Paul D Danielson, Elizabeth Renaud, Saleem Islam
BACKGROUND: Omphaloceles can be some of the more challenging cases managed by pediatric surgeons. Single center studies have not been meaningful in delineating outcomes due to the length of time required to accumulate a large enough series with historical changes in management negating the results. The purpose of this study was to evaluate factors impacting the morbidity and mortality of neonates with omphaloceles. METHODS: A multicenter, retrospective observational study was performed for live born neonates with omphalocele between 2005 and 2013 at nine centers in the United States...
October 22, 2018: Journal of Pediatric Surgery
Brent Bauman, Daniel Stephens, Hannah Gershone, Connie Bongiorno, Erin Osterholm, Robert Acton, Donavon Hess, Daniel Saltzman, Bradley Segura
PURPOSE: Despite the numerous methods of closure for giant omphaloceles, uncertainty persists regarding the most effective option. Our purpose was to review the literature to clarify the current methods being used and to determine superiority of either staged surgical procedures or nonoperative delayed closure in order to recommend a standard of care for the management of the giant omphalocele. METHODS: Our initial database search resulted in 378 articles. After de-duplification and review, we requested 32 articles relevant to our topic that partially met our inclusion criteria...
October 2016: Journal of Pediatric Surgery
Emily A Partridge, William H Peranteau, Alan W Flake, N Scott Adzick, Holly L Hedrick
PURPOSE: Giant omphalocele (GO) is a challenging problem owing to aberrant anatomy and complex comorbidities. Large inguinal hernias (IH) are known to occur in this population, but have not been well described in the literature. We sought to characterize rates and complications of IH in GO patients. METHODS: A retrospective chart review was performed on all patients with the diagnosis of GO from 2004 to 2012, with a minimum follow-up period of 12 months. Statistical significance was calculated using Fisher's exact test and Mann-Whitney test (p<0...
October 2015: Journal of Pediatric Surgery
E Frigo, S Rettinger-Schimmerl, A M Rokitansky
A new technique of umbilicoplasty in neonates who underwent primary omphalocele repair is described and illustrated. The procedure resulted in a nearly-normal appearance of the umbilicus.
1999: Pediatric Surgery International
J E Uceda
A newborn with a large omphalocele is presented. A new technique of umbilical preservation is introduced. The cosmetic result was excellent, and the method is suitable for both primary and staged omphalocele repairs.
November 1994: Journal of Pediatric Surgery
Beau Aldridge, Alan P Ladd, Jacqueline Kepple, Teresa Wingle, Christopher Ring, Evan R Kokoska
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...
March 2016: American Journal of Surgery
Mario Zama, Simona Gallo, Luigino Santecchia, Ettore Bertozzi, Antonio Zaccara, Alessandro Trucchi, Antonella Nahom, Pietro Bagolan, Cosmoferruccio De Stefano
Omphalocele is the most common congenital defect of the abdominal wall. Mortality rate is between 20 and 70% and early closure of the abdominal wall, within 10 days of life, is vital to the successful outcome of the surgical treatment. The authors describe the use of two bipedicled flaps of abdominal skin to correct the defect of the midline as soon as the reduction of all viscera has been accomplished.
December 2004: British Journal of Plastic Surgery
Marcial Oquendo, Vaidehi Agrawal, Roxana Reyna, Haroon I Patel, Mohammad A Emran, P Stephen Almond
OBJECTIVE: We successfully employed silver-impregnated hydrofiber dressing for management of giant omphaloceles (GO) followed by delayed surgical closure. STUDY DESIGN: Between 2005 and 2008, eight consecutive GO infants were cared for at Driscoll Children's Hospital. Four patients had additional congenital anomalies including Beckwith-Wiedemann (n = 1), tetralogy of Fallot (n = 1), pulmonary hypoplasia (n = 1), and ruptured omphalocele (n=1). Infants underwent amnion epithelization using a silver-impregnated hydrofiber dressing over the course of several months followed by delayed surgical closure...
October 2015: Journal of Pediatric Surgery
Susan L Wilcinski
Wound healing is a complex process that can be even more challenging in neonatal and pediatric patients. Infants and children have special characteristics such as skin immaturity, a high body surface to weight ratio, sensitivity to pain, increased potential for percutaneous absorption of medication, and an immature immune system that adds to the complexity of treating their wounds. The use of controlled topical negative pressure across a wound surface has been used in adults and children since 1995. Recently, the use of this device has been reported in neonates...
June 2010: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
D Dachev, E Zanzov, P Stefanova
Omphalocele is a congenital abdominal wall defect. The treatment is surgical on one or multiple stages for the giant forms of the anomaly. It is a challenge for the pediatric surgeons while omphalocele is a giant one and it is impossible to insert all the organs in the abdominal cavity. The treatment and the hospitalization of the child are quite long. The authors present a case--a newborn with a omphalocele and share their experience. This method gives good results, shorten the treatment and the stay in hospital...
2014: Khirurgiia
Kandice E Kilbride, Donald R Cooney, Monford D Custer
INTRODUCTION: Closure of giant omphalocele can present a surgical challenge. Neither silo, skin flap, nor primary closure has been successful in treating all patients. We present a novel application of the vacuum-assisted closure (VAC) device, which allows for improved results in these difficult cases. METHODS: The VAC device (KCI, San Antonio, Tex) consisted of a sponge applied directly to the bowel and liver, covered with impermeable transparent dressing, and attached to a low negative pressure system...
January 2006: Journal of Pediatric Surgery
Floortje C van Eijck, Rene M H Wijnen, Harry van Goor
BACKGROUND/PURPOSE: Adhesive small bowel obstruction (SBO) is a feared complication after correction of abdominal wall defects in neonates. Knowledge of its incidence and potential risk factors in a well-documented group with strict follow-up is needed to guide preventive measures. METHODS: Records of 170 neonates with abdominal wall defects, 59 gastroschisis (GS) and 111 omphalocele (OC), were reviewed focusing on SBO. Risk of SBO was calculated, and potential risk factors were analyzed...
March 2008: Journal of Pediatric Surgery
Floortje C van Eijck, Leo A van Vlimmeren, René M H Wijnen, Willemijn Klein, Iris Kruijen, Sigrid Pillen, Maria W G Nijhuis-van der Sanden
BACKGROUND/PURPOSE: The objective of this study was to evaluate the long-term functional and motor development and abdominal muscle quantity in children operated on for giant omphalocele (GOC) with the Component Separation Technique (CST). METHODS: Between 2004 and 2007, CST was applied in eleven consecutive infants with GOC. Eight underwent ultrasound of the abdominal wall and muscles, assessment of functional and motor development using the Movement Assessment Battery for Children, 2nd Edition (M-ABC-2), and an observational physical examination focused on possible abnormalities in stature and movements related to GOC...
March 2013: Journal of Pediatric Surgery
Floortje C van Eijck, Ivo de Blaauw, Robert P Bleichrodt, Paul N M A Rieu, Frans H J M van der Staak, Marc H W A Wijnen, Rene M H Wijnen
BACKGROUND/PURPOSE: Several techniques have been described to repair giant omphaloceles. There is no procedure considered to be the criterion standard worldwide. The aim of the present prospective study was to analyze the early and late results of secondary closure of giant omphaloceles using the component separation technique (CST) in infants. METHODS: From January 2004 to January 2007, 10 consecutive pediatric patients with a giant omphalocele were treated at our department...
January 2008: Journal of Pediatric Surgery
Shauna Levy, KuoJen Tsao, Charles S Cox, Uma R Phatak, Kevin P Lally, Richard J Andrassy
PURPOSE: Operative repair of large abdominal wall defects in infants and children can be challenging. Component separation technique (CST) is utilized in adults to repair large abdominal wall defects but rarely used in children. The purpose of this report is to describe our experience with the CST in pediatric patients including the first description of CST use in newborns. METHODS: After IRB approval, we reviewed all patients who underwent CST between June 1, 2010 and December 31, 2012 at a large children's hospital...
December 2013: Journal of Pediatric Surgery
Adesola C Akinkuotu, Fariha Sheikh, Oluyinka O Olutoye, Timothy C Lee, Cariciolo J Fernandes, Stephen E Welty, Nancy A Ayres, Darrell L Cass
BACKGROUND: The purpose of this study was to describe the current management and outcomes of infants with omphalocele. METHODS: The medical records of all patients treated for omphalocele at a large children's hospital from January, 2003-February, 2014 were reviewed. Patients were classified as having an isolated omphalocele or omphalocele with minor or major associated anomalies. Prenatal data collected included fetal magnetic resonance imaging-based observed-to-expected total fetal lung volumes...
October 2015: Journal of Surgical Research
Chandrasen K Sinha, Masih Kader, Evelyn Dykes, A J Said
INTRODUCTION: This was a retrospective 18 years' review of infants with exomphalos with particular attention to its association with malrotation. MATERIALS AND METHODS: We reviewed all exomphalos cases presenting to our neonatal surgery unit, from October 1991 to September 2009. Data were presented as median and range values. Categorical data were analyzed using Fisher's exact tests and P value of ≤0.05 was considered as significant. RESULTS: Forty-two infants with exomphalos (E...
November 2011: Pediatric Surgery International
A Binet, T Gelas, S Jochault-Ritz, O Noizet, J P Bory, F Lefebvre, M Belouadah, I James-Robert, D Aubert, M A Bouche-Pillon Persyn, M L Poli-Merol, C François-Fiquet
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)...
December 2013: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Sigmund H Ein, Jacob C Langer
BACKGROUND/PURPOSE: To assess the value of topical silver sulfadiazine (SSD) cream in the treatment of babies with a giant omphalocele. METHODS: From 1991 to 2008 inclusive, 20 infants with giant omphalocele (defined as >10 cm diameter) were treated with SSD, leaving a large ventral hernia to be repaired at a later date. RESULTS: There were 12 boys and 8 girls. Thirteen had prenatal ultrasound diagnosis at a mean gestational age of 23 weeks...
March 2012: Journal of Pediatric Surgery
Stephen Almond, Roxana Reyna, Natalie Barganski, Mohammad A Emran
The surgical management of a giant omphalocele is challenging. Many cannot be closed at birth and must initially be managed nonoperatively with a topical agent to facilitate epithelialization. We report the case of a term, 1-day-old female neonate with a giant omphalocele treated initially with a hydrofiber dressing containing silver (Aquacel Ag; ConvaTec Inc, Skillman, NJ) and then with delayed primary closure.
July 2010: Journal of Pediatric Surgery
2014-10-16 01:38:47
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