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.
Keywords
gastroschisis - omphalocele - vacuum-assisted closure - VAC - negative-pressure wound
therapy
