Serial Reduction of an Extremely Large Gastroschisis using Vacuum-Assisted Closure

European Journal of Pediatric Surgery Reports

Marilyn W. Butler¹  Julie Fuchs²  Matias Bruzoni² 

[1] Division of Pediatric Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, United States;Division of Pediatric Surgery, Department of Surgery, Stanford University, Stanford, California, United States;

关键词: gastroschisis;    omphalocele;    vacuum-assisted closure;    vac;    negative-pressure wound therapy;   

DOI  :  10.1055/s-0038-1676045

来源: DOAJ

【 摘 要 】

We herein describe a case of serial reduction of an extremely large and complex gastroschisis using vacuum-assisted closure (VAC) therapy in a boy born at 355/7 weeks' gestation. A spring-loaded silicone silo was placed at birth. By day of life (DOL) 22, minimal visceral contents had been reduced, and the silo was difficult to maintain due to the size of the fascial defect and loss of abdominal domain. A bespoke VAC dressing was constructed, and biweekly dressing changes allowed gradual reduction of the gastroschisis until the viscera were consolidated. By DOL 50, the viscera were completely reduced, and VAC therapy was discontinued. Feeds were commenced on DOL 57 and increased to goal by DOL 86. The baby was discharged home on DOL 115. We conclude that VAC dressings can be used to aid gradual reduction of an extremely large gastroschisis, particularly in medical fragile infants.

【 授权许可】

Unknown