Negative pressure wound therapy for initial management of giant omphalocele

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 omphaloce...

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Bibliographic Details
Published in:The American journal of surgery 2016-03, Vol.211 (3), p.605-609
Main Authors: Aldridge, Beau, M.D, Ladd, Alan P., M.D, Kepple, Jacqueline, NP, Wingle, Teresa, PT, Ring, Christopher, B.S, Kokoska, Evan R., M.D
Format: Article
Language:English
Subjects:
Abdomen
Adhesives
Children & youth
Defects
Enteral Nutrition
Female
Hernia, Umbilical - therapy
Humans
Infant, Newborn
Male
Methods
Negative pressure wound therapy
Omphalocele
Patients
Retrospective Studies
Surgery
Time Factors
Treatment Outcome
Wound Healing - physiology
Wound VAC
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Summary: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 cm2 . 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.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2015.11.009