Abstract
Introduction
A new technique of gastroschisis closure in which the defect is covered with sterile
dressings and allowed to granulate without suture repair was first described in 2004.
Little is known about the outcomes of this technique. This study evaluated short-term
outcomes from the largest series of sutureless gastroschisis closures.
Methods and Patients
A retrospective case control study of 26 patients undergoing sutureless closure between
2006 and 2008 was compared to a historical control group of 20 patients with suture
closure of the abdominal fascia between 2004 and 2006. Four major outcomes were assessed:
(1) time spent on ventilator, (2) time to initiating enteral feeds, (3) time to discharge
from the neonatal intensive care unit, and (4) rate of complications.
Results
In multivariate analysis, sutureless closure of gastroschisis defects independently
reduced the time to extubation as compared to traditional closure (5.0 vs 12.1 days,
P = .025). There was no difference in time to full enteral feeds (16.8 vs 21.4 days,
P = .15) or time to discharge (34.8 vs 49.7 days, P = .22) with sutureless closure. The need for silo reduction independently increased
the time to extubation (odds ratio, 4.2; P = .002) and time to enteral feeds (odds ratio, 5.2; P < .001). Small umbilical hernias were seen in all patients.
Conclusion
Sutureless closure of uncomplicated gastroschisis is a safe technique that reduces
length of intubation and does not significantly alter the time required to reach full
enteral feeds or hospital discharge.
Key words
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Article info
Publication history
Accepted:
March 16,
2009
Received:
November 5,
2008
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
