Assessment of Silver Sulfadiazine Dressing in the Non-Operative Management of Omphalocele

Abstract

Background: Non-operative management of omphalocele, a congenital abdominal wall defect involving abdominal viscera protrusion through the umbilical cord base, poses significant neonatal care challenges. Silver sulfadiazine dressing, renowned for its antimicrobial and wound-healing properties, is emerging as a potential adjunctive therapy for omphalocele. Aim of the study: This study aimed to assess the effectiveness of silver sulfadiazine dressing in the non-operative management of omphalocele. Methods: This prospective interventional study was carried out at Dhaka Medical College and Hospital (DMCH), Dhaka, Bangladesh, from March 2018 to June 2020. The study included 10 neonates with omphalocele who received silver sulfadiazine dressing. Random sampling was employed for participant selection, and data were collected using a pre-designed data collection sheet. Analysis and presentation of data were done using the MS Office suite. Results: The average age of the participants was 1.0±1.15 years, and 60% of them were male. Participants with omphaloceles showed diverse sac sizes, with 10% having sacs ≤5 cm, and 90% >5 cm (mean 7.30 cm ± 2.58 cm). Eschar formation took 7.70±2.62 days. Initial hospital stays averaged 9.10±1.91 days. Epithelization commenced in 18.90±3.60 days. Full epithelization across participants averaged 103.30±16.74 days. Conclusion: Eschar formation and initial hospital stays are as expected, but complete epithelization is significantly prolonged, highlighting the need for ongoing care. Our recommendation for medical practitioners is to tailor care to omphalocele patients, especially regarding epithelization management, considering individual needs and optimizing the process.