Michael Helmrath · Sutureless vs sutured abdominal wall closure for gastroschisis: Operative characteristics and early outcomes from the Midwest Pediatric Surgery Consortium
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Article1 min read·Published Feb 2020Older

Sutureless vs sutured abdominal wall closure for gastroschisis: Operative characteristics and early outcomes from the Midwest Pediatric Surgery Consortium

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Article · Feb 2020 · 1 min read

In brief

In brief

Multi-institutional retrospective study comparing sutureless versus sutured abdominal wall closure in 315 neonates with uncomplicated gastroschisis. Sutureless closure was associated with reduced anesthesia exposure, ventilator time, antibiotic use, and fewer infections, with benefits observed in both primary closure and post-silo reduction groups.

Written by the GCMD Library team from the article.

Michael Helmrath

Purpose: To report outcomes of sutured and sutureless closure for gastroschisis across a large multi-institutional cohort. Methods: A retrospective study of infants with uncomplicated gastroschisis at 11 children's from 2014 to 2016 was performed. Outcomes of sutured and sutureless abdominal wall closure were compared. Results: Among 315 neonates with uncomplicated gastroschisis, sutured closure was performed in 248 (79%); 212 undergoing sutured closure after silo and 36 undergoing primary sutured closure. Sutureless closure was performed in 67 (21%); 37 primary sutureless closure, 30 sutureless closure after silo placement. There was no significant difference in gestational age, gender, birth weight, total days on TPN, and time from closure to initial oral intake or goal feeds. Sutureless closure patients had less general anesthetics, ventilator use/time, time from birth to final closure, antibiotic use after closure, and surgical site/deep space infections. Subgroup analysis demonstrated primary sutureless closure had less ventilator use and anesthetics than primary sutured closure. Sutureless closure after silo led to less ventilator use/time, anesthetics, and antibiotics compared to those with sutured closure after silo. Conclusion: Sutureless abdominal wall closure of neonates with gastroschisis was associated with less general anesthetics, antibiotic use, surgical site/deep space infections, and decreased ventilator time. These findings support further prospective study

Statements in this article

  1. Among 315 neonates with uncomplicated gastroschisis, sutured closure was performed in 248 (79%) and sutureless closure in 67 (21%).

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  2. Of sutured closures, 212 underwent sutured closure after silo and 36 underwent primary sutured closure.

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  3. Of sutureless closures, 37 underwent primary sutureless closure and 30 underwent sutureless closure after silo placement.

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  4. There was no significant difference between sutured and sutureless closure groups in gestational age, gender, birth weight, total days on TPN, time from closure to initial oral intake, or time to goal feeds.

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  5. Sutureless closure patients had fewer general anesthetics compared to sutured closure patients.

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  6. Sutureless closure patients had less ventilator use and shorter ventilator time compared to sutured closure patients.

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  7. Sutureless closure patients had shorter time from birth to final closure compared to sutured closure patients.

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  8. Sutureless closure patients had less antibiotic use after closure compared to sutured closure patients.

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  9. Sutureless closure patients had fewer surgical site and deep space infections compared to sutured closure patients.

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  10. Primary sutureless closure had less ventilator use and fewer anesthetics than primary sutured closure.

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  11. Sutureless closure after silo led to less ventilator use, shorter ventilator time, fewer anesthetics, and less antibiotic use compared to sutured closure after silo.

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