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Description of a Modification of the Staged Treatment for Large Defects

Walton K. T. Shim, MD

AMA Arch Surg. 1971;102(5):524-529.

Abstract
In three cases of gastroschisis the first patient was treated by immediate skin coverage and fascial repair 20 months later; the second was treated by segmental intestinal resection, but the infant died after 3 weeks following another exploration for obstruction; and the last patient was treated by temporary enclosure of the intestines with a silicone and polyester sack. Attention is called to the importance of pulling the rectus edges together by lateral plication of the sack after the intestines have been squeezed into the abdomen. Defects over 4 cm cannot be closed with safety unless the sack is gradually plicated. Supportive measure to conserve heat and ventilatory reserve are urged.

Author Affiliations
Honolulu

From the Department of Surgery, Kauikeolani Children's Hospital and University of Hawaii School of Medicine, Honolulu.

Footnotes
Accepted for publication Nov 2, 1970.

Read before the Paediatric Surgical Congress and the Pacific Association of Pediatric Surgeons, Royal Children's Hospital Centennial, Melbourne, Australia, March 19, 1970.

Reprint requests to 1481 S King St, Honolulu 96814.

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