Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients
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In brief
In brief
This prospective study of 16 newborns with giant omphalocele or complicated gastroschisis demonstrates that a novel vertical traction device (fasciotens®Pediatric) enables early tension-free fascial closure within 4-22 days. The technique achieved complete closure without compartment syndrome, surgical site infections, or hernia formation at 12-month follow-up.
- Vertical traction device (fasciotens®Pediatric) achieved complete fascial closure in median 7 days for giant omphalocele, 5 days for gastroschisis
- Traction-assisted staged closure avoided abdominal compartment syndrome and surgical site infections in all 16 newborn patients
- No ventral or umbilical hernias occurred at median 12-month follow-up, suggesting durable tension-free closure
- Minimal complications: 2 traction suture tear-outs and 1 skin dehiscence across 16 cases with complex abdominal wall defects
- Early definitive closure in newborn period is achievable for giant omphalocele and complicated gastroschisis using continuous traction technique
Written by the GCMD Library team from the article.
Abstract
Purpose
Abdominal wall closure in patients with giant omphalocele (GOC) and complicated gastroschisis (GS) remains to be a surgical challenge. To facilitate an early complete abdominal wall closure, we investigated the combination of a staged closure technique with continuous traction to the abdominal wall using a newly designed vertical traction device for newborns.
Methods
Four tertiary pediatric surgery departments participated in the study between 04/2022 and 11/2023. In case primary organ reduction and abdominal wall closure were not amenable, patients underwent a traction-assisted abdominal wall closure applying fasciotens®Pediatric. Outcome parameters were time to closure, surgical complications, infections, and hernia formation.
Results
Ten patients with GOC and 6 patients with GS were included. Complete fascial closure was achieved after a median time of 7 days (range 4–22) in GOC and 5 days (range 4–11) in GS. There were two cases of tear-outs of traction sutures and one skin suture line dehiscence after fascial closure. No surgical site infection or signs of abdominal compartment syndrome were seen. No ventral or umbilical hernia occurred after a median follow-up of 12 months (range 4–22).
Conclusion
Traction-assisted staged closure using fasciotens®Pediatric enabled an early tension-less fascial closure in GOC and GS in the newborn period.