Operative versus conservative treatment for giant omphalocele: Study of French and Ivorian management

Binet, A.; Scalabre, Aurélien; Amar, S.; Alzahrani, Khalid M.; Boureau, C; Bastard, François; Lefebvre, F; Koffi, Maxime; Sounkere, M.; Nasser, D.; Ouattara, O.; Kouamé, B.; Lardy, H.

doi:10.1016/j.anplas.2019.03.004

Cited by 9 publications

(8 citation statements)

References 25 publications

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“…Omphalocele is one of the most common congenital abdominal wall defects seen in approximately one in 4000-7000 live births [1]. It is associated with an under-developed abdominal cavity and a high visceral-abdominal disproportion that prevents safe primary closure [2].…”

Section: Introductionmentioning

confidence: 99%

Management of Giant Omphalocele Leading to Early Fascial Closure

Dörterler

2019

Cureus

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ObjectiveThe aim of the study was to present the clinical outcomes of patients diagnosed with giant omphalocele, treated with early primary closure combined with bandaging and povidone-iodine staining and powder spray antibiotics.Materials and methodsThe study included a total of 22 infants with omphalocele. The omphalocele sacs of the patients were cleaned daily with topical povidone-iodine. A powdered spray antibiotic combination was then applied topically twice a day and the sac was wrapped in a sterile elastic bandage. Following the observation of eschar formation and epithelization, the patients were operated on in the early period and the sac was removed by placing a graft.ResultsEvaluation was made of a total of 14 female and eight male patients with mean duration of conservative monitoring of 11 days and mean total hospital stay of 35. The mean giant omphalocele (GO) defect size of the patients followed-up was 10 cm. Since seven of the patients in the present study died in the 1st week, conservative and elastic bandages were applied for the GO treatment of 15 patients for 9-14 days. After the conservative follow-up, it was determined that the patients who were applied with a graft at an average of 11 days were hospitalized for an average of 24 days postoperatively.ConclusionIn conclusion, it is possible to reduce the length of hospital stay with primary closure in the early period by providing faster epithelialization with the combination of povidone-iodine and antibiotic powder together with elastic bandage application in infants with GO.

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Section: Introductionmentioning

confidence: 99%

Management of Giant Omphalocele Leading to Early Fascial Closure

Dörterler

2019

Cureus

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“…12,17,18,20,[40][41][42][43] More recent studies with diluted applications show the agents' blood level to be at the upper end of normal, but with no associated complications. 7,8,13,34,35,38 There are more reports describing less toxic agents, like honey and saline, to avoid the risk of toxicity with comparative length of hospital stays and time to full epithelialisation of the sac. 5,10,24,25 Alcohol was one of the earliest agents used to paint giant omphalocoele sacs due to its efficacy as an antiseptic that was found to be more dependent on its concentration rather than the type of alcohol applied.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies that report high blood levels of these agents seem to be older studies, where applications used to have a higher concentration 12,17,18,20,40–43 . More recent studies with diluted applications show the agents' blood level to be at the upper end of normal, but with no associated complications 7,8,13,34,35,38 . There are more reports describing less toxic agents, like honey and saline, to avoid the risk of toxicity with comparative length of hospital stays and time to full epithelialisation of the sac 5,10,24,25 …”

Section: Discussionmentioning

confidence: 99%

Choice of topical substances in the conservative management of Exomphalos – A systematic review

Goneidy,

Saxena

2023

Acta Paediatrica

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AimExomphalos is a congenital anomaly found in 1/4500 newborns. Choice of non‐operative management of exomphalos major unamenable to primary repair is controversial. This study aims at reviewing conservative management modalities and compare outcomes and complications.MethodsA systematic review was performed according to PRISMA guidelines of all English publications in MEDLINE and EMBASE databases. Search words were exomphalos OR omphalocoele AND conservative OR non‐operative AND management. Studies were scrutinised for patient demographics, co‐morbidities, mode of treatment, time to full feeds, time to full epithelialisation, length of stay, complications and mortality. Studies not specifically describing mode of management and/or describing primary or staged surgical repairs were excluded.ResultsInitial search resulted in 1243 studies. Forty‐two studies were deemed suitable offering 822 patients for analysis after excluding duplicates and non‐eligible studies. Management methods varied including painting with Alcohol, Mercurochrome, silver products, Povidone Iodine, honey and other materials. Mortality was mostly due to associated anomalies. There was mixed reporting of alcohol, silver, Povidone Iodine and mercury toxicity as well as infection during the course of treatment.ConclusionThis report has recognised the variations in topical substances employed for conservative management with no clear consensus. Reports on safety of different methods remain unclear.

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“…The treatment of giant omphaloceles is still controversial. In developed countries, surgery is systematic [9]. In our context, this surgery is only reserved for small omphaloceles or in cases of rupture of the sac.…”

Section: Discussionmentioning

confidence: 99%

Giant Omphalocele Ruptured: An Operated Case and Review of the Literature

Koffi¹,

Evelyne²,

Gaudens³

et al. 2020

OJPed

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Background: The omphalocele is a congenital defect of closure of the abdominal wall at the level of the umbilical ring with evisceration of the intra-abdominal organs in the form of a bag covered with a membrane. This membrane can rupture and become an extreme emergency that can put the infant's life at stake. Aim: The purpose of this case report is to present a case of ruptured omphalocele operated successfully and describe the factors of good prognosis. Case Presentation: A female newborn with a giant omphalocele. This omphalocele ruptured during conservative treatment. An emergency surgery was organised and the defect was closed by using a prosthesis. The postoperative course was simple. During the 12 months follow-up, we have seen no complication. Conclusion: The management of ruptured omphaloceles is a surgical and anesthetic challenge. The mortality of this condition can be improved in our context by setting up well-equipped neonatal resuscitation units.

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Operative versus conservative treatment for giant omphalocele: Study of French and Ivorian management

Cited by 9 publications

References 25 publications

Management of Giant Omphalocele Leading to Early Fascial Closure

Management of Giant Omphalocele Leading to Early Fascial Closure

Choice of topical substances in the conservative management of Exomphalos – A systematic review

Giant Omphalocele Ruptured: An Operated Case and Review of the Literature

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