DELAYED PRIMARY CLOSURE OF GIANT OMPHALOCELE: GRADUAL CLOSED-REDUCTION FOLLOWED BY OPEN FASCIAL CLOSURE
Keywords:
Omphalocele, Exomphalos, Giant omphalocele, Abdominal wall defect, Delayed primary closureAbstract
Objectives: To introduce the new technique of gradual closed-reduction followed by open fascial closure and to
assess its clinical outcome in our setup.
Material and Methods: It was a prospective and descriptive study. It was conducted at the Department of Pediatric
Surgery, Post Graduate Medical Institute, Lady Reading Hospital, Peshawar from January 2003 to December 2007.
All patients with giant omphalocele (base-diameter more than 5 cm in width) including ruptured ones were first
managed with conservative treatment using mercurochrome (0.5-1%) solution and were then admitted to the hospital
after the age of 06 months. Small omphaloceles were excluded from the study. A thorough clinical examination and
relevant investigations were performed in all patients.
Results: A total of 18 children with giant omphalocele were treated with this technique. There were 10 (55.55%)
female and 8 (44.44%) male patients. Age ranged from 6-24 months. Hospital stay was from 12-15 days. No mortality
was observed and no major complications (abdominal wound dehiscence, compromised venous return, respiratory
discomfort or cyanosis) were seen. Mild wound infection (local erythema and / or purulent discharge) was seen in
3 (16.66%) patients, fever up to 102F0 in 9(50.00%) patients and mild respiratory embarrassment in 5 (27.77%)
patients.
Conclusion: Delayed primary closure of giant omphalocele by this technique is a safe and effective way of treatment
particularly in places where neonatal and pediatric ICU facilities are not available.
Downloads
Published
How to Cite
Issue
Section
License
All articles published in the Journal of Medical Sciences (JMS) are licensed under the Creative Commons Attribution 4.0 International License (CC-BY 4.0). Under the CC BY 4.0 license, author(s) retain the ownership of the copyright publishing rights without restrictions for their content, and allow others to copy, use, print, share, modify, and distribute the content of the article even for commercial purposes as long as the original authors and the journal are properly cited. No permission is required from the author/s or the publishers for this purpose. Appropriate attribution can be provided by simply citing the original article. The corresponding author has the right to grant on behalf of all authors, a worldwide license to JMS and its licensees in all forms, formats, and media (whether known now or created in the future), The corresponding author must certify and warrant the authorship and proprietorship and should declare that he/she has not granted or assigned any of the article’s rights to any other person or body.
The corresponding author must compensate the journal for any costs, expenses, or damages that the JMS may incur as a result of any breach of these warranties including any intentional or unintentional errors, omissions, copyright issues, or plagiarism. The editorial office must be notified upon submission if an article contains materials like text, pictures, tables, or graphs from other copyrighted sources. The JMS reserves the right to remove any images, figures, tables, or other content, from any article, whether before or after publication, if concerns are raised about copyright, license, or permissions and the authors are unable to provide documentation confirming that appropriate permissions were obtained for publication of the content in question.
