The use of preformed spring loaded Silo on delayed primary closure of gastroschisis patients at the Philippine Children's Medical Center

ABSTRACT

@#<p style="text-align: justify;"><strong>RATIONALE:</strong> The objective of the study was to describe the outcome in a series of patients with delayed primary closure of gastroschisis using a Preformed Spring-Loaded Silo Bag (PSLS).</p><p style="text-align: justify;"><strong>METHODS:</strong> A prospective data collection and chart review were done all gastroschisis patients from May 2011 to April 2013. Eligible gastroschisis patients were applied with silo bag, gradual reduction of abdominal viscera and elective abdominal wall closure. The post- operative  outcomes  investigated  were:  infection  rate,  days  to immediate fascial closure, post-operative ventilatory period, post-operative  NPO  period  to  successful  enteral  feeding,  days  in  the NICU, days of hospital admission, development of post-operative complications, and mortality rate.</p><p style="text-align: justify;"><strong>RESULTS:</strong> Thirty-four  gastroschisis  patients  were  admitted  from May  2011  to  April  2013,  of  whom  25  patients  qualified  for  the study.  Majority  of  the  patients  were  female,  preterm,  delivered vaginally, weighed <2kg admittted within the first 24hrs of life. 84% had prenatal ultrasound, less 50% were diagnosed correctly. 48% of mothers were less than 20 years old. Fascial closure rate was 88% (delayed abdominal closure done within 10 days). 72% were fed within 10 days after delayed abdominal wall closure. 52% were extubated within 24 hours. Average hospital stay was 35 days. Overall outcome: morbidity rate- 48%; home against medical advice (HAMA)-4%; mortality rate - 12%.</p><p style="text-align: justify;"><strong>CONCLUSIONS:</strong> The use of PSLS bags for the delayed primary closure of gastroschisis appears to be a safe and beneficial.</p>