Original article| Volume 44, ISSUE 10, P1947-1951, October 2009

Download started.


Outcomes of sutureless gastroschisis closure



      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.


      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.


      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

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Sandler A.
        • Lawrence J.
        • Meehan J.
        • et al.
        A “plastic” sutureless abdominal wall closure for gastroschisis.
        J Pediatr Surg. 2004; 39: 738-741
        • Spitz L.
        A historical vignette: gastroschisis.
        J Pediatr Surg. 2008; 43: 1396-1397
        • Siverio N.H.
        • Fernandez E.M.
        • Luque J.M.
        Gastroschisis: primary closure using umbilical cord strengthened by polypropylene mesh.
        J Perinat Med. 2007; 35: 249-251
        • Weinsheimer R.L.
        • Yanchar N.L.
        • Bouchard S.B.
        • et al.
        Gastroschisis closure—does method really matter?.
        J Pediatr Surg. 2008; 43: 874-878
        • Alvarez S.M.
        • Burd R.S.
        Increasing prevalence of gastroschisis repairs in the United States: 1996 – 2003.
        J Pediatr Surg. 2007; 42: 943-946
        • Loane M.
        • Dolk H.
        • Bradbury I.
        Increasing prevalence of gastroschisis in Europe 1980-2002: a phenomenon restricted to younger mothers?.
        Paediatric Perinat Epidemiol. 2007; 21: 361-369
        • Kidd J.N.
        • Jackson R.J.
        • Smith S.D.
        • et al.
        Evolution of staged versus primary closure of gastroschisis.
        Ann Surg. 2003; 237: 759-765
        • Bonnard A.
        • Zamakshary M.
        • de Silva N.
        • et al.
        Non-operative management of gastroschisis: a case-matched study.
        Pediatr Surg Int. 2008; ([Electronic publication ahead of print])
        • Miller J.D.
        • Carlo W.A.
        Pulmonary complications of mechanical ventilation in neonates.
        Clin Perinatol. 2008; 35: 273-281
        • Foglia E.
        • Meier M.D.
        • Elward A.
        Ventilator-associated pneumonia in neonatal and pediatric intensive care unit patients.
        Clin Microbiol Rev. 2007; 20: 409-425
        • Abdullah F.
        • Arnold M.A.
        • Nabaweesi R.
        • et al.
        Gastroschisis in the United States 1988-2003: analysis and risk categorization of 4344 patients.
        J Perinatol. 2007; 27: 50-55