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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Anna-Maria Ziegler, Daniel Svoboda, Britta Lüken-Darius, Andreas Heydweiller, Fritz Kahl, Sophie Christine Falk, Udo Rolle, Till-Martin Theilen
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.
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Can a novel vertical traction device help facilitate early abdominal wall closure in children with congenital abdominal wall defects? I'm Alex Halpern, a research fellow from Children's National, and this is an article that you should know. Ziegler et al. performed the prospective study in 10 patients with giantumphalocele and 6 with complicated gastroschisis, trying to answer this question. They utilized fascia tenses pediatric, a traction-assisted abdominal wall closure device. They were able to achieve complete fascial closure after a median time of 7 days in children with giant um. and 5 days in children with complicated gastroschisis. No patients developed abdominal compartment syndrome, and no ventral hernias occurred after a median follow-up of 12 months. So it seems like fascia tends pediatric helps facilitate early fascial closure in these patients. Do you want to give fascia tends a try? Let us know what you think in the comments below.