The Use of Preformed Spring-Loaded Silo on Delayed Primary Closure of Gastroschisis Patients at the Philippine Children’s Medical Center

Abstract

Rationale: The objective of the study was to describe the outcome in a series of patients with delayed primary closure of gastroschisis using a Preformed Spring-Loaded Silo Bag (PSLS). Methods: A prospective data collection and chart review were done all gastroschisis patients from May 2011 to April 2013. Eligible gastroschisis patients were applied with silo bag, gradual reduction of abdominal viscera and elective abdominal wall closure. The postoperative outcomes investigated were: infection rate, days to immediate fascial closure, post-operative ventilatory period, postoperative NPO period to successful enteral feeding, days in the NICU, days of hospital admission, development of post-operative complications, and mortality rate. Results: Thirty-four gastroschisis patients were admitted from May 2011 to April 2013, of whom 25 patients qualified for the study. Majority of the patients were female, preterm, delivered vaginally, weighed<2 kg and admitted within the first 24hrs of life. 84% had prenatal ultrasound, less 50% were diagnosed correctly. 48% of mothers were less than 20 years old. Fascial closure rate was 88% (delayed abdominal closure done within 10 days). 72% were fed within 10 days after delayed abdominal wall closure. 52% were extubated within 24 hours. Average hospital stay was 35 days. Overall outcome: morbidity rate- 48%; home against medical advice (HAMA)-4%; mortality rate – 12%. Conclusions: The use of PSLS bags for the delayed primary closure of gastroschisis appears to be a safe and beneficial. Key words: gastroschisis, preformed spring-loaded silo bag, infant newborn, abdominal wall, viscera