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Kidd, Joseph N.; Jackson, Richard J.; Smith, Samuel D.; Wagner, Charles W.

doi:10.1097/00000658-200306000-00003

Cited by 13 publications

(8 citation statements)

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“…OA management is achieved by leaving the fascia and the skin open, and temporarily covering the viscera. An OA with temporary abdominal closure (TAC) may also be necessary following operations in which edematous viscera preclude easy fascial closure, management of abdominal wall defects or in which an adult size organ has been transplanted into a small child [22, 34, 52, 53, 55, 70, 71]. The ultimate goal of OA management is to achieve prompt primary fascial closure without complications.…”

Section: Resultsmentioning

confidence: 99%

“…Temporary abdominal closure (TAC) techniques have recently been characterized into three generations reflecting the historical evolution of the devices, from simple coverings, to contain the viscera, to closure devices to cover and aid in the gradual approximation of the abdominal edges [9, 42, 70, 72, 73]. The first generation aimed at bridging the defect and covering the abdomen, using biodegradable or synthetic materials.…”

Section: Resultsmentioning

confidence: 99%

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Abdominal Decompression in Children

Ejike

Mathur

2012

Critical Care Research and Practice

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Abdominal compartment syndrome (ACS) increases the risk for mortality in critically ill children. It occurs in association with a wide variety of medical and surgical diagnoses. Management of ACS involves recognizing the development of intra-abdominal hypertension (IAH) by intra-abdominal pressure (IAP) monitoring, treating the underlying cause, and preventing progression to ACS by lowering IAP. When ACS is already present, supporting dysfunctional organs and decreasing IAP to prevent new organ involvement become an additional focus of therapy. Medical management strategies to achieve these goals should be employed but when medical management fails, timely abdominal decompression is essential to reduce the risk of mortality. A literature review was performed to understand the role and outcomes of abdominal decompression among children with ACS. Abdominal decompression appears to have a positive effect on patient survival. However, prospective randomized studies are needed to fully understand the indications and impact of these therapies on survival in children.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Abdominal Decompression in Children

Ejike

Mathur

2012

Critical Care Research and Practice

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“…Selection of the method of closure can clearly bias the conclusions of the study, which is highlighted in studies that compared primary closure to patients receiving a silo after failure of primary closure (Table 1) (15, 25, 28, 34, 35). Patients receiving a silo because primary closure has failed most likely represent a patient population prone to worse clinical outcomes (38).…”

Section: Discussionmentioning

confidence: 99%

“…Placement of a SLS has the theoretical benefit of allowing the bowel edema to resolve, allowing partial reduction of the intestine and reduced intra-abdominal pressures at the time of definitive fascial closure (12, 14). It is postulated that reduction of bowel in the setting of reduced intra-abdominal pressures improves splanchnic perfusion resulting in faster return of bowel function and reduced rates of infection and necrotizing enterocolitis (NEC) (14, 15, 16). …”

mentioning

confidence: 99%

Primary fascial closure versus staged closure with silo in patients with gastroschisis: A meta-analysis

Kunz

Tieder

Whitlock³

et al. 2013

Journal of Pediatric Surgery

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Background/Purpose Gastroschisis is the most common congenital abdominal wall defect. Despite advances in the surgical closure of gastroschisis, consensus is lacking as to which method results in the best patient outcomes. The purpose of this meta-analysis was to compare short-term outcomes associated with primary fascial closure and staged repair with a silo in patients with gastroschisis. Methods We reviewed Medline citations, as well as the Cochrane Database of Systematic Reviews, between January 1, 1996 and June 1, 2012. Articles were identified using the search term “gastroschisis” and [(“treatment outcome” or “prognosis”) or randomized controlled trials]. Case reports, reviews, letters, abstracts only, non-English abstracts, and studies that did not address at least one of the outcomes of interest were excluded from the meta-analysis. Two independent reviewers identified relevant articles for final inclusion. A standard data collection form created by the authors was used to extract study information, including study design, patient characteristics, and reported patient outcomes. The data were analyzed using standard meta-analytic techniques. Results Twenty studies were included in the meta-analysis. In the five studies that selected closure method randomly or as a temporal shift in practice, silo was associated with better outcomes, with a significant reduction in ventilator days (p<0.0001), time to first feed (p=0.04), and infection rates (p=0.03). When all studies were included, primary closure was associated with improved outcomes. Conclusions Silo closure is associated with better clinical outcomes in the studies with the least selection bias. Larger prospective studies are needed to definitively determine the best closure technique.

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“…Some authors have found better results by inserting a spring-loaded silo and allowing the gradual reduction of the viscera in patients whenever primary closure is not possible [24][25][26][27][28]. In 2001, our center began to routinely insert a spring-loaded silo in the NICU, whenever primary reduction of the viscera was not readily achievable.…”

Section: Discussionmentioning

confidence: 99%