Staged Closure of Gastroschisis using Alexis Wound Retractor and Protector

Achariya Tongsin, Rangsan Niramis, Veera Buranakitjaroen, Varaporn Mahatharadol, Wannisa Poocharoen and Suranetr Laorwong

Department of Surgery, Queen Sirikit National Institute of Child Health, Thailand

^*Correspondance to: Achariya Tongsin 

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Abstract:

Background: Gastroschisis is the most common congenital anterior abdominal wall defect. The principle of management is to reduce the eviscerated content safely and to close the abdominal wall defect with an acceptable cosmetic appearance.
Objectives: Compare the using of Steri-drape Artificial Sac (SAS) and Alexis Wound Protector and Retractor (AWR) for staged closure of gastroschisis.
Methods: A retrospective study of patients with gastroschisis who were treated by staged closure at Queen Sirikit National Institute of Child Health between January 2013 and December 2016 was conducted. Patient’s information was compared between the usage of SAS and AWR regarding demographic data, operative procedure and results of treatment. The statistical differences were analyzed by the Chi-square, Fisher exact and student t-test with p-value less than 0.05 considered significant. Patients who had associated intestinal atresia or perforation were excluded.
Results: Eighty-four patients with gastroschisis were treated by staged closure (SAS: 39, AWR: 45). Average gestational age, birth weight, maternal age and defect size in both groups were not significantly different (p>0.05). AWR placements were performed at bedside 33 cases, in the operating room 7 cases. The AWR group had shorter operative time for placement and abdominal wall closure than SAS group significantly (p<0.001). Regarding duration of parenteral nutrition, duration of ventilator support and length of stay, significantly shorter in the AWR group (p<0.05). There were no complications attributed to AWR placement.
Conclusion: Staged closure of gastroschisis with AWR is simple, convenient and safe technique, in addition, to avoid anesthetic risk in the first day of life and good cosmetic appearance.

Keywords:

Gastroschisis; Staged closure; Steri-drape artificial sac; Alexis wound protector and retractor; Surgical management

Cite the Article:

Tongsin A, Niramis R, Buranakitjaroen V, Mahatharadol V, Poocharoen W, Laorwong S. Staged Closure of Gastroschisis using Alexis Wound Retractor and Protector. World J Surg Surgical Res. 2018; 1: 1036.