Cosmetic Outcomes of Sutureless Closure in Gastroschisis

Zając, Andrzej; Bogusz, Bartosz; Sołtysiak, Piotr; Tomasik, Przemysław; Wolnicki, Michał; Wędrychowicz, Andrzej; Wojciechowski, Piotr; Górecki, Wojciech

doi:10.1055/s-0035-1570759

Cited by 11 publications

(2 citation statements)

References 21 publications

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“…In comparison, IV analgesia requirements showed a slower trend downward over time and may represent changes in NICU management. Cosmetic outcomes were not specifically evaluated in the study, but anecdotally and according to another study, 19 sutureless repair may be associated with excellent cosmesis.…”

Section: Limitationsmentioning

confidence: 99%

Evaluation of Clinical Outcomes of Sutureless vs Sutured Closure Techniques in Gastroschisis Repair

et al. 2019

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IMPORTANCE Sutureless gastroschisis repair offers an alternative to the traditional sutured method and has been associated with decreased intubation time. Published study results are inconsistent regarding the advantages of sutureless closure. OBJECTIVE To compare the clinical outcomes of sutureless and sutured gastroschisis repair. DESIGN, SETTING, AND PARTICIPANTS A single-center cohort review was performed of all consecutive patients (n = 97) who underwent gastroschisis repair from February 1, 2007, to April 30, 2017, at the University of California, San Francisco. Patients' medical records were evaluated for clinical characteristics and outcomes. Cases with incomplete data during initial hospitalization were excluded. MAIN OUTCOMES AND MEASURES Length of hospital stay, time to full enteral feeds, total parenteral nutrition duration, days requiring intravenous analgesia, days intubated, wound infection rate, antibiotic treatment duration, rate of umbilical hernias that required an operation, and readmission rate. RESULTS In total, 97 patients (47 [48%] were female and 50 [52%] were male with a mean [SD] age of 2.8 [2.8] days) underwent gastroschisis repair, of which 7 were excluded for incomplete medical record. Of the 90 patients included in the study, 50 (56%) underwent sutured closure and 40 (44%) underwent sutureless closure. No statistical difference was found between the sutured and sutureless groups in length of hospital stay (mean [SD] days, 43.9 [40.4] vs 36.7 [21.2]; P = .71), time to full enteral feeds (mean [SD] days, 31.4 [20.2] vs 27.9 [17.3]; P = .22), total parenteral nutrition duration (mean [SD] days, 33.5 [29.8] vs 27.4 [18.2]; P = .23), wound infection rates (14 [28%] vs 10 [25%]; P = .81), and readmission rates (5 [10%] vs 7 [18%]; P = .36). The sutureless group, compared with the sutured group, had substantially fewer days receiving antibiotics (mean [SD], 7.2 [6.4] vs 12.4 [13.2]; P = .003), fewer days intubated (mean [SD], 2.8 [3.3] vs 6.8 [1.3]; P = .001), fewer days receiving intravenous analgesia (mean [SD], 4.2 [4.0] vs 7.1 [4.5]; P = .003), and fewer patients that required silo reduction (25 [63%] vs 48 [96%]; P < .001). Sutureless closures, compared with the sutured technique, had considerably more umbilical hernias requiring surgical repair (5 [13%] vs 0; P = .02). CONCLUSIONS AND RELEVANCE Sutureless repair of gastroschisis appears to be associated with a statistically significant reduction in mechanical ventilation duration and pain medication requirements but may increase umbilical hernia risk. Multicenter randomized clinical trials are necessary to determine the true advantages of the sutureless approach.

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Section: Limitationsmentioning

confidence: 99%

Evaluation of Clinical Outcomes of Sutureless vs Sutured Closure Techniques in Gastroschisis Repair

et al. 2019

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“…SSA provides excellent esthetic results with minimal scar formation [ 17 ]. SSA transfers the procedure from the OR to the bedside, thus lowering the financial burden on both hospitals and families [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Sutureless Approach for Gastroschisis Patients in Palestine

Abuzneid

Abukhalaf

Rabi

et al. 2020

Case Reports in Surgery

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Gastroschisis is a ventral abdominal wall congenital defect with bowel herniation outside the abdominal cavity. Gastroschisis traditional management is the primary operative closure surgery (POCS), but the sutureless silo approach (SSA), a novel alternative, gains wide acceptance in the developed countries and across nations. This study describes the first-ever gastroschisis patient managed with the sutureless silo approach in Palestine. In addition, we shall use this case as the very first nucleus for the upcoming gastroschisis management in our referral hospital because the SSA yields a reduced hospital stay which is fundamental to our institution due to the limited number of beds and lower management costs to the hospital and families.

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Newborn Abdominal Wall Defects

Polites¹,

Nathan²

2021

Pediatric Gastrointestinal and Liver Disease

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Cosmetic Outcomes of Sutureless Closure in Gastroschisis

Cited by 11 publications

References 21 publications

Evaluation of Clinical Outcomes of Sutureless vs Sutured Closure Techniques in Gastroschisis Repair

Evaluation of Clinical Outcomes of Sutureless vs Sutured Closure Techniques in Gastroschisis Repair

Sutureless Approach for Gastroschisis Patients in Palestine

Newborn Abdominal Wall Defects

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