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.
Keywords
gastroschisis - preformed silo - surgery
