2005
DOI: 10.1007/s00383-005-1518-2
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Gastroschisis reduction using “Applied Alexis”, a wound protector and retractor

Abstract: We used an Applied Alexis (Applied Medical Resources Corp, USA) wound protector and retractor (WPAR) instead of a "spring loaded silo" (SLS) for gastroschisis reduction because SLS is currently unavailable in Japan. Our patient was a 1,707 g female diagnosed prenatally with gastroschisis born at 35 weeks gestation by spontaneous vaginal delivery. Attempted primary closure failed and a WPAR was used as a silo. A piece of the bottom ring of the WPAR was cut out and a smaller ring was made from it, so it would fi… Show more

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Cited by 23 publications
(18 citation statements)
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“…Miranda et al, searching for inexpensive alternatives to be used in developing countries, used sterile polyvinyl chloride blood transfusion bags as silon pouches [6]. Recently, a wound protector was successfully used to prepare the abdominal cavity to accept the bowel without associated complications [7]. However, in spite of the evidence that the type of closure does not affect overall mortality [13], some reports associated the use of these pouches to an increase in mortality, especially because of infection and sepsis, strengthening the idea that primary closure should be performed whenever possible [14][15][16].…”
Section: Discussionmentioning
confidence: 98%
See 1 more Smart Citation
“…Miranda et al, searching for inexpensive alternatives to be used in developing countries, used sterile polyvinyl chloride blood transfusion bags as silon pouches [6]. Recently, a wound protector was successfully used to prepare the abdominal cavity to accept the bowel without associated complications [7]. However, in spite of the evidence that the type of closure does not affect overall mortality [13], some reports associated the use of these pouches to an increase in mortality, especially because of infection and sepsis, strengthening the idea that primary closure should be performed whenever possible [14][15][16].…”
Section: Discussionmentioning
confidence: 98%
“…A large number of prosthetic materials have been used as silon pouches for staged closure of gastroschisis [4][5][6][7]. However, most of these techniques involve submitting the newborn to a lengthy surgical procedure under general anesthesia in the first hours of life.…”
Section: Introductionmentioning
confidence: 99%
“…These cases will require either primary or delayed bowel lengthening procedures [62]. Available silo materials [55,59,60].…”
Section: Intra-operative Decision Makingmentioning
confidence: 99%
“…Recently, three new procedures and devices for complex cases of gastroschisis reduction have been reported, such as 'spring-loaded silo', 'applied Alexis', and 'negative pressure wound therapy', with a pump for negative pressure and interface kits [3,4]. Although all of these techniques have a broad indication field, they can hardly be applied in most underdeveloped countries because of their high price, and sometimes they are unavailable even in developed countries [5]. These devices and materials as foreign bodies and 'dead' materials, cannot benefit from the normal healing process, which yields a scar between the artificial material and surrounding tissue.…”
Section: Introductionmentioning
confidence: 99%