Implementing a standardized gastroschisis protocol significantly increases the rate of primary sutureless closure without compromising closure success or early clinical outcomes
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In brief
In brief
Retrospective study (2008-2019) demonstrates that implementing a standardized gastroschisis protocol significantly increased bedside sutureless closures from 35% to 95% without affecting closure success rates or early outcomes. Multi-disciplinary practice bundles can shift closure approach while maintaining safety in uncomplicated gastroschisis cases.
Written by the GCMD Library team from the article.
Purpose
Standardized protocols have been shown to improve outcomes in several pediatric surgical conditions. We implemented a multi-disciplinary gastroschisis practice bundle at our institution in 2013. We sought to evaluate its impact on closure type and early clinical outcomes.
Methods
We performed a retrospective review of uncomplicated gastroschisis patients treated at our institution between 2008-2019. Patients were divided into two groups (pre- and post-protocol implementation). Multivariate logistic regression was used to compare closure location, method, and success.
Results
Neonates (pre-implementation n=53, post-implementation n=43) were similar across baseline variables. Successful immediate closure rates were comparable (75.5% vs. 72.1%, p=0.71). The proportion of bedside closures increased significantly after protocol implementation (35.3% vs. 95.4%, p