Implementing a standardized gastroschisis protocol significantly increases the rate of primary sutureless closure without compromising closure success or early clinical outcomes
Topic overview
Implementation of a standardized gastroschisis protocol dramatically increased bedside sutureless closures (from 32.5% to 71.0%) and reduced mechanical ventilation duration without increasing complications. The multi-disciplinary practice bundle shifted 95% of closures to bedside approach while maintaining equivalent success rates and clinical outcomes.
Key takeaways
- Standardized gastroschisis protocol increased bedside closures from 35% to 95% without compromising closure success rates (75% vs 72%).
- Sutureless closure rates increased significantly from 33% to 71% after protocol implementation with equivalent complication rates.
- Median postoperative mechanical ventilation decreased from 4 days to 2 days following protocol adoption.
- Infants had 44× higher odds of bedside closure and 7.7× higher odds of sutureless closure after protocol implementation.
- Multidisciplinary practice bundles can improve surgical efficiency in gastroschisis without increasing complications or TPN duration.
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