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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Topic overview
ABSTRACT
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
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