Identifying strategies to decrease infectious complications of gastroschisis repair

Schlueter, Rachel K; Azarow, Kenneth S.; Hines, Andrea Green; Varman, Meera; Abdessalam, Shahab; Raynor, Stephen C.; Cusick, Robert A.

doi:10.1016/j.jpedsurg.2014.10.001

Cited by 25 publications

(18 citation statements)

References 17 publications

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“…[29][30][31] This remains controversial. More recent studies show worse outcomes with early delivery, including an increased risk of infectious complications 32 and poorer long-term neurodevelopmental outcomes. 33 Maramreddy et al found gastroschisis patients delivered prior to 37 weeks gestation had a 14 times greater risk of morbidities than patients carried to term.…”

Section: Discussionmentioning

confidence: 99%

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Necrotizing Enterocolitis following Gastroschisis Repair: An Update

Schlueter¹,

Abdessalam²,

Raynor³

et al. 2019

GMERJ

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Purpose: Purpose: Necrotizing enterocolitis (NEC) is a known complication of gastroschisis with an incidence above the expected rate in the neonatal population. While many physicians today are aware of this association, the last publication to explore this association in detail and identify possible risk factors of NEC in gastroschisis patients was published over twenty years ago. From our large database of patients with gastroschisis managed by a single group of pediatric surgeons, we reviewed our experience and the recent literature to update what is known about gastroschisis and NEC. Methods: Methods: From 2001 to 2017, a gastroschisis registry was maintained. Data from 218 gastroschisis patients were reviewed. Patient demographics and hospital course were reviewed. Patients with confirmed NEC were compared to those without NEC. Results Results: Two hundred eighteen patients were born with gastroschisis during the time frame of this study. We observed a 5% rate (11 of 218) of NEC. Five patients (45%) developed recurring NEC and 4 patients (36%) were readmitted for NEC development following initial discharge. Variables associated with NEC included low gestational age (P=0.016) and low birth weight (P=0.003). Patients born prior to 37 weeks gestation had a 4.8 times greater risk of developing NEC than those born at term. Rates of IUGR were not statistically different between NEC and non-NEC patients. The method of delivery (cesarean vs vaginal), use of a silo, and form of nutrition were not significantly associated with NEC development. Conclusions Conclusions: The overall incidence of NEC has decreased compared to earlier reports. NEC does complicate the hospital course for patients, significantly increasing duration of in-hospital treatment. NEC in gastroschisis differs in comparison to traditional NEC, presenting later in life. Risk factors identified include low gestational age and low birth weight. Avoiding elective preterm deliveries may decrease the rate of NEC in gastroschisis.

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Section: Discussionmentioning

confidence: 99%

“…33 Pre-term, low birth weight infants have been identified as being at increased risk of infection. 32 Patients who developed NEC were on average 1.5 weeks younger at birth and weighed 484 grams less. Infants not carried to term were found to be 4.8 times more likely to develop NEC than infants carried to term.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing Enterocolitis following Gastroschisis Repair: An Update

Schlueter¹,

Abdessalam²,

Raynor³

et al. 2019

GMERJ

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“…13 This method was first described in 2004, and multiple retrospective case series since then have advocated the efficacy and safety of suture-less closure. [14][15][16][17][18] While not the focus of this study, we had six enrolled patients who underwent a sutureless technique, four in the PC and two in the DC. Two of these patients developed umbilical hernias (one PC and one DC).…”

Section: Discussionmentioning

confidence: 99%

Primary Closure versus Bedside Silo and Delayed Closure for Gastroschisis: A Truncated Prospective Randomized Trial

et al. 2018

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“…Doğum şeklinin enfeksiyon gelişimine etkisi yoktur. Bu bilgiler doğrultusunda terminde doğum, silodan kaçınmak ve özellikle sü-türsüz primer onarım tekniklerini kullanmak enfeksiyonu önleyecektir (117) .…”

Section: Prognosti̇k Gastroşi̇zi̇s Skoruunclassified

Abdominal wall defects: omphalocele and gastrschisis

Yazıcı¹

2017

tcdd

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Identifying strategies to decrease infectious complications of gastroschisis repair

Cited by 25 publications

References 17 publications

Necrotizing Enterocolitis following Gastroschisis Repair: An Update

Necrotizing Enterocolitis following Gastroschisis Repair: An Update

Primary Closure versus Bedside Silo and Delayed Closure for Gastroschisis: A Truncated Prospective Randomized Trial

Abdominal wall defects: omphalocele and gastrschisis

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