Preformed Silos versus Traditional Abdominal Wall Closure in Gastroschisis: 163 Infants at a Single Institution

Paul Charlesworth*, Ibiyinka Akinnola, Charlotte Hammerton, Pranithia Praveena, Ashish Desai, Shailesh Patel, Mark Davenport

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Introduction
The surgical management of gastroschisis (GS) is controversial. The most commonly used strategy for abdominal wall closure is surgery on day 1 of life with the aim of primary closure (PC) or construction of a surgical silo (SS) and secondary closure thereafter. The other widely used technique is application of a preformed silo (PFS) and reduction of contents over a few days before final closure. There is still a paucity of comparative outcome data.

Methods
A retrospective case note review of all infants initially treated at a single institution between October 1993 and October 2012. PFS was adopted as the technique of choice in April 2005. Infants with closed or closing GS were excluded. Data are presented as median (range). p<0.05 were significant.

Results
There were 163 infants (156 complete data sets). PFSs were applied in 67 infants and PC/SS were applied in 89 infants of whom 19 infants required a SS. There was no statistical difference between gestational age (p=0.8), birth weight (p=0.7), time to first (p=0.07) and full enteral feeding (p=0.08), length of hospital stay (p=0.17), or necrotizing enterocolitis (p=0.4) and mortality (p=0.4). Infants treated with PC+SS were closed on day 0 (range, 0-11 days) versus day 6 (range, 2-22 days) of life (p<0.001). PC + SS were ventilated for day 5 (range, 1-22 days) versus day 3.5 (range, 0-20 days) days (p=0.01).

Conclusion
Infants treated with PFS required less ventilation than those treated by PC+SS. There was no difference in time to full feeds, length of hospital stay mortality or morbidity.

Original languageEnglish
Pages (from-to)88-93
Number of pages6
JournalEuropean Journal of Pediatric Surgery
Volume24
Issue number1
DOIs
Publication statusPublished - Feb 2014

Keywords

  • gastroschisis
  • preformed silo
  • surgery
  • SPRING-LOADED SILO
  • MANAGEMENT
  • REDUCTION
  • OUTCOMES
  • REPAIR

Fingerprint

Dive into the research topics of 'Preformed Silos versus Traditional Abdominal Wall Closure in Gastroschisis: 163 Infants at a Single Institution'. Together they form a unique fingerprint.

Cite this