CC BY 4.0 · European J Pediatr Surg Rep. 2018; 06(01): e97-e99
DOI: 10.1055/s-0038-1676045
Case Report
Georg Thieme Verlag KG Stuttgart · New York

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

Marilyn W. Butler
1   Division of Pediatric Surgery, Department of Surgery, Oregon Health and Science University, Portland, Oregon, United States
,
Julie Fuchs
2   Division of Pediatric Surgery, Department of Surgery, Stanford University, Stanford, California, United States
,
Matias Bruzoni
2   Division of Pediatric Surgery, Department of Surgery, Stanford University, Stanford, California, United States
› Author Affiliations
Further Information

Publication History

04 July 2018

11 October 2018

Publication Date:
26 December 2018 (online)

Abstract

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.

 
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