Practice variation in gastroschisis: Factors influencing closure technique

Gastroschisis. Case report and management in primary care services

“…Some of the factors associated with the success of primary closure include patients classified as low risk and born intrainstitutionally and in reference centers. (27) On the other hand, gradual closure has some advantages over the primary closure, such as lower incidence of compartment syndrome and intra-abdominal hypertension, lower requirement of mechanical ventilation and vasoactive support. (28) Regarding the surgical technique, in recent years the sutureless closure technique has been implemented using flaps with autologous tissue, mainly umbilical cord.…”

A Systematic Review

“…It has been used internationally in countries including: United States of America (USA), 15–19 Canada, 20–32 Spain, 33–35 Italy, 36,37 Brazil, 12,38 India, 39,40 France, 41 Thailand, 42 Netherlands, 43 Ireland, 44 China, 45 and Iran 46 . Two studies had cohorts that were derived from populations across two countries including the USA and Canada.…”

“…Three large neonatal networks participated in several studies including the Canadian Pediatric Surgery Network (CAPSNet), 20,21,24–26 Canadian Neonatal Network (CNN), 6,22,27,29–32 and the Vermont Oxford Network (VON). 6,16,17,47 The sample sizes varied greatly among the studies as shown in Table 2.…”

“…Some studies specifically focused on very low birth weight newborns 19,44,48 and extremely low gestational age newborns 16,17 which are premature populations with expected risk of illness severity. Not only was the SNAP-II used across all gestational ages and birth weights, it was also used across many specific morbidities including: congenital diaphragmatic hernia, 15,21,24,25,28,29 chorioamnionitis, 27,48 sepsis, 33–36,39 gastroschisis, 20,26 patent ductus arteriosus, 19,22 persistent pulmonary hypertension, 42 and respiratory distress. 45 …”

“…Furthermore, most of the studies used a 12-hour data collection window for the SNAP-II score per the initial instrument design. 6,16,18,20,25–32,41,42,45,47,48 However, three studies expanded the data collection period to 24 hours. 15,23,43 Finally, three studies did not clearly report when the assessment was done and how many hours were used for the data collection window.…”