A successful early gore‐tex reconstruction of an abdominal wall defect in a neonate with Cantrell pentalogy: a case report and literature review

Divković, Dalibor; Kvolik, Slavica; Sipl, Mirna; Šego, Krunoslav; Pušeljić, Silvija; Rakipović-Stojanović, Andreja; Kovačić, Borna

doi:10.1002/ccr3.137

Cited by 14 publications

(16 citation statements)

References 15 publications

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“…Abdominal wall defects are repaired by mobilization and gradually stretching of the abdominal muscles with the priority being to preserve intestinal blood flow and achieve a low-tension midline closure. Residual defects that cannot be closed primarily may be covered by the placement of a biocompatible or polytetrafluoroethylene (Gore-Tex) patch (37). The application of a sclerosing solution to promote formation of an amniotic sac eschar has been described in the conservative management of omphalocoeles, with plans to repair the resulting abdominal wall hernia at a later date (14).…”

Section: Initial Management and Surgical Repairmentioning

confidence: 99%

“…Although not routinely measured, the Pediatric Sub-Committee of the World Society of the Abdominal Compartment Syndrome recommended the use of intraabdominal pressure (IAP) monitoring in the critically-ill patient (38). Divkovic et al suggested that complication of increased IAP such as ventilator dependency, reherniation, and gut ischemia may be prevented by IAP monitoring in the neonatal intensive care unit (37). Clinical studies investigating a critical IAP level in neonates need to be undertaken and may guide further recommendations.…”

Section: Initial Management and Surgical Repairmentioning

confidence: 99%

“…Other cardiac postoperative complications include residual shunt and low cardiac output syndrome/cardiac insufficiency. Late mortality is usually due to a complication of cardiac dysfunction, infections, or adhesive small bowel obstruction (37).…”

Section: Short and Long-term Outcomesmentioning

confidence: 99%

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Pentalogy of Cantrell

Williams

Marayati

Beierle

2019

Seminars in Pediatric Surgery

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Pentalogy of Cantrell is a constellation of five congenital defects that pose a unique challenge for surgeons. Defects of the heart, pericardium, diaphragm, sternum, and anterior abdominal wall are pathognomonic. Although the incidence of this defect is small, it is critical to identify it in a timely fashion in order to adequately address all aspects. Early diagnosis, supportive care, and strategic surgical planning with a multidisciplinary team are all key components in managing patients with Pentalogy of Cantrell. In this text we sought to explore the evolution of both the understanding and treatment for this complex entity and provide current recommendations to today's pediatric caregivers.

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Section: Initial Management and Surgical Repairmentioning

confidence: 99%

Section: Initial Management and Surgical Repairmentioning

confidence: 99%

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Pentalogy of Cantrell

Williams

Marayati

Beierle

2019

Seminars in Pediatric Surgery

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“…The prevalence of PC is 1:65,000 live births, with a 37% survival rate [ 4 ]. Surgical treatment should be performed at the earliest to prevent cardiac trauma; however, surgery depends on the size of the sternal defect, and the use of autologous tissues is preferable [ 5 ]. In this article, the authors present a case of PC diagnosed in the second trimester, focusing on the main ultrasound and fetal echocardiography findings as well as on delivery planning and surgical correction in the postnatal period.…”

Section: Introductionmentioning

confidence: 99%

Pentalogy of Cantrell: Prenatal Diagnosis, Delivery, and Immediate Postnatal Surgical Repair

et al. 2017

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Pentalogy of Cantrell (PC) is a congenital anomaly characterized by a defect in the lower sternum, anterior diaphragm, and anterior abdominal wall; ectopia cordis; and congenital heart disease. It is a very rare congenital anomaly and the prenatal diagnosis is possible in the beginning of second trimester of pregnancy using the conventional ultrasonography. The prognosis is poor with high rates of perinatal mortality. We present a case report of prenatal diagnosis of PC at 22 weeks and 3 days of gestation. We emphasize the prenatal care follow up in a tertiary reference center, the parental counseling, the planning of delivery, and the management of newborn by a multidisciplinary team, including the description of immediate postnatal surgical repair.

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“…Abdominal wall defects (giant omphalocele and gastroschisis) and diaphragmatic hernia repair has historically seen the use of prosthetic patches of non-absorbable materials (Dacron, Polypropylene, Goretex, Goretex dual mesh with antibiotic) which represented a valid solution. However, they are not integrated in the surrounding tissues and can be a source of infection and complications in the medium–long term [1] , [2] , [3] . In the newborn, particularly in case of abdominal wall defects, the prosthesis is usually covered with very thin skin flaps, with poor representation of the subcutaneous tissue, increasing the risk of skin necrosis, infection and recurrence of the defect.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and properties of the biological prosthesis Permacol™ in pediatric surgery: A large single center experience

Filisetti

Costanzo

Marinoni

et al. 2016

Annals of Medicine &Amp; Surgery

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IntroductionThe use of prosthetic patches of non-absorbable materials represents a valid tool in the treatment of abdominal wall and diaphragmatic defects in pediatric age. In recent years research has developed biological dermal scaffolds made from a sheet of acellular matrix that can provide the desired support and reduce the occurrence of complications from non-absorbable implant. We present our experience and a systematic review to evaluate the use of biologic prosthesis for abdominal wall closure in pediatric patients.MethodsThe study from January 2009 to January 2015 involved 20 patients treated with Permacol™ implant. We observed postoperative complications only in patients treated for abdominal wall closure, which is the major indication for the use of Permacol™. We conducted a systematic review and meta-analysis (according to PRISMA) on PubMed/Medline, Scopus and EMBASE regarding the use of biological prosthesis in pediatric population considering the incidence of complications as the primary outcome.Results3/20 patients experienced complications: 2 patients with skin necrosis healed conservatively and 1 of them developed laparocele. Thus only 1 patient with incisional hernia had significant surgery complication. In patients who were permanently implanted with Permacol™ it has not determined adverse reactions with optimal functional outcome.ConclusionsIn accordance with the few data (case reports and case series) reported in literature about pediatric patients, our experience in different pathologies and applications has shown the effectiveness of Permacol™, in particular for the non-occurrence of infections, that often affect the use of prosthesis.

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A successful early gore‐tex reconstruction of an abdominal wall defect in a neonate with Cantrell pentalogy: a case report and literature review

Cited by 14 publications

References 15 publications

Pentalogy of Cantrell

Pentalogy of Cantrell

Pentalogy of Cantrell: Prenatal Diagnosis, Delivery, and Immediate Postnatal Surgical Repair

Effectiveness and properties of the biological prosthesis Permacol™ in pediatric surgery: A large single center experience

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