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Staged gastroschisis closure using Alexis wound retractor: first experiences

Abstract :

INTRODUCTION: The aim of this study is to analyze the effectiveness of an Alexis wound retractor (AWR) device for staged gastroschisis closures.

PATIENTS AND METHODS: AWR device was used to cover unreduced viscera of a gastroschisis when primary abdominal wall closure was not convenient. The eviscerated organs were covered with one of the two spring-loaded rings of the AWR inserted underneath the abdominal wall. Gradual reduction was guaranteed through careful traction on the external ring. We retrospectively analyzed the prenatal, post-natal and operative data of the first patients treated with AWR and report their post-operative outcomes.

RESULTS: The AWR device was used for staged closure in eight cases. Complete reduction and fascial closure were performed at a median of 3.5 ± 1.6 days. Ventilatory support was necessary for 4.0 ± 3 days and full parenteral feeds for 7.5 ± 6.1 days after fascial closure. Median full enteral feeding was observed at 18 ± 12.5 days after closure allowing discharge in a median period of 30.5 ± 15.6 days after closure.

CONCLUSION: The AWR device is not only a safe and efficient silo for a progressive reduction of severe gastroschisis, but also an interesting tool for continuous stretching leading to an increase of the peritoneal cavity volume, enhancing the equalizing of the viscero-abdominal disproportion.

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Article dans une revue
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Soumis le : jeudi 24 juin 2021 - 10:57:44
Dernière modification le : lundi 14 novembre 2022 - 01:44:05




Cindy Ferreira, Isabelle Lacreuse, Dorothée Geslin, Françoise Schmitt, Anne Schneider, et al.. Staged gastroschisis closure using Alexis wound retractor: first experiences. Pediatric Surgery International, 2014, 30 (3), pp.305-311. ⟨10.1007/s00383-013-3440-3⟩. ⟨hal-03269627⟩



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