Abdominal Defects Research Articles

Soft, Long-Lived, Bioresorbable Electronic Surgical Mesh with Wireless Pressure Monitor and On-Demand Drug Delivery.

Current research in the area of surgical mesh implants is somewhat limited to traditional designs and synthesis of various mesh materials, whereas meshes with multiple functions may be an effective approach to address long-standing challenges including postoperative complications. Herein, a bioresorbable electronic surgical mesh is presented that offers high mechanical strength over extended timeframes, wireless post-operative pressure monitoring, and on-demand drug delivery for the restoration of tissue structure and function. The study of materials and mesh layouts provides a wide range of tunability of mechanical and biochemical properties. Dissolvable dielectric composite with porous structure in a pyramidal shape enhances sensitivity of a wireless capacitive pressure sensor, and resistive microheaters integrated with inductive coils provide thermo-responsive drug delivery system for an antibacterial agent. In vivo evaluations demonstrate reliable, long-lived operation, and effective treatment for abdominal hernia defects, by clear evidence of suppressed complications such as adhesion formation and infections.

Long-term motor activity, cardiopulmonary performance and quality of life in abdominal wall defect patients

AimTo assess whether patients born with an abdominal wall defect (AWD) have impaired cardiorespiratory performance capacity, motor skills, core stability or quality of life in a long-term follow up.MethodsPatients diagnosed with AWD between 2002 and 2013 were invited to participate in the study, which included clinical examination, spirometry, cardiopulmonary exercise performance testing, assessment of motor activity, ultrasound, electromyography of the abdominal wall and assessment of the Gastrointestinal Quality of Life Index (GIQLI). The results were compared to a healthy control group matched for age, sex, BMI, and physical activity levels.ResultsIn total, 18 AWD patients (mean age 12.6 ± 3.5 years) were included and there were no significant differences in anthopometric data compared to the control group (n = 18). AWD patients had a significantly lower GIQLI score (AWD mean 137.2 ± 6.8 vs. control mean 141.4 ± 4.9; p = 0.038) and were affected by decreased motor abilities with significantly higher Dordel-Koch-Test values (AWD median 3.54/IQR 1 vs. control median 2.8/IQR 1; p = 0.005).ConclusionFollow-up examinations of AWD patients revealed decreased motor abilities and GIQLI scores while cardiopulmonary function was not different compared to healthy controls. The clinical impact of these findings remains to be elucidated.ImpactClinical examination, assessment of the gastrointestinal quality of life, sport medical testing, electromyography and abdominal wall ultrasound were performed in patients with congenital abdominal wall defect and compared to an age and sex matched healthy control group.Results of spirometry and spiroergometry, ultrasound or electromyography did not significantly differ between the groups.Significantly decreased locomotor function and gastrointestinal quality of life were found in patients with abdominal wall defect. However, the clinical impact of these findings remains to be elucidated.

Perforated Meckel´s diverticulum in large omphalocele: a case report

Omphalocele is a midline abdominal wall defect that can be associated with other abnormalities. In this case report, we present a case of a newborn male with a perforated Meckel's diverticulum adherent within an omphalocele and intestinal malrotation; a very few cases of the coexistence of Omphalocele and Meckel's diverticulum have been described, so we highlight the multidisciplinary management. Consent to publish the case report was not obtained. This report does not contain any personal information that could lead to the identification of the patient. Since this is a case report we didn’t use any statistical tool. The validity and reliability of this case due to its detailed clinical account, citation of existing literature, and adherence to established medical knowledge.

ABDOMINAL WALL DEFECTS: GASTROSCHISIS, DEFINITION, EPIDEMIOLOGY, PATHOGENESIS, TYPES, DIAGNOSIS AND MANAGEMENT

Introduction: Abdominal wall defects are common congenital anomalies, both gastroschisis and omphalocele conform to fetal developmental anomalies that favor multidisciplinary support before and after birth. Outcomes for newborns with gastroschisis usually depend on the distinctive features of the abdominal wall defect and underlying intestinal viability, whereas omphalocele outcomes are determined by the size of the defect and the presence of other related anomalies. Objective: to detail current information related to the two fetal abdominal wall defects, especially gastroschisis definition, epidemiology, pathogenesis, types, diagnosis and management. Methodology: a total of 48 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 36 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: fetal abdominal wall defects, gastroschisis, prenatal anomalies, surgery and prosthetic silo. Results: The incidence of gastroschisis ranges from 0.4 to 3 per 10,000 births and shows an upward pattern, the incidence of omphalocele ranges from 1.5 to 3 per 10,000 births. About 10% of infants with gastroschisis have intestinal stenosis or atresia because of vascular insufficiency due to volvulus or compression of the vascular pedicle by a narrowing abdominal ring. Periconceptional genitourinary tract infections were significantly associated with gastroschisis (OR, 1.5; 95 % CI, 1.3 to 1.9). Other significant associations presented in various studies with gastroschisis pregnancies include smoking (odds ratio (OR), 2.86; 95 % CI, 2.22-3.66), history of pregestational or gestational diabetes (OR, 2.81; 95 % CI, 1.42-5.5), and use of antidepressant medications (OR, 4.4; 95 % CI, 1.38-11.8). Conclusions: Abdominal wall defects are common congenital anomalies, both gastroschisis and omphalocele represent different embryological outcomes, which depend on accurate prenatal diagnosis and referral to a multidisciplinary fetal center. Gastroschisis is a congenital anomaly of the rudimentary umbilical ring, in which there is herniation of a variable portion of viscera through the defect, with no membrane or covering sac, and its prevalence has been steadily increasing. Gastroschisis is classified into simple and complex types. Prenatal ultrasound scans can diagnose gastroschisis as early as 12 weeks of gestation. Routine preterm delivery or elective cesarean section has not been shown to improve outcome. Surgical management after birth is aimed at reduction of the herniated viscera and closure of the abdominal wall. Survival rates are usually high; however, the prognosis depends on the state of the bowel at birth. Those affected with significant intestinal alteration at birth are at higher risk of premature death or later complications. Future fetal surgery could improve the outlook and management of the condition. KEY WORDS: gastroschisis, abdominal wall defect, congenital.

Lumbar hernia: An unusual abdominal hernia: A case report and review of literature (radiological perspective) in a tertiary center in south-south Nigeria

Lumbar hernias are unusual abdominal wall defects involving the posterolateral abdominal wall: the superior lumbar triangle of Grynfelt, which is the most common site, and the inferior lumbar triangle of Petit. They are located between the muscular layers of the abdominal wall and can be easily ignored because of abdominal obesity. In general, it is difficult to diagnose because of their unclear non-specific symptoms. However, radiographic studies have been valuable in confirming the diagnosis. The introduction of ultrasonography and computed tomography (CT) has greatly improved the diagnosis of lumbar hernia. Following the establishment of the diagnosis, operative management is indicated due to chance of incarceration. Our case study is an 80 years old man who presented to the Radiology department for an emergency abdominal ultrasound scan investigation on account of abdominal pain/abdominal swelling on the lateral aspect of the right flank of about 5 days as explained by his relative. The abdominal ultrasound shows a hyperechoic mass in the right flank that extends through a defect in the transversus abdominis muscle. This mass measures 5.3x4.9cm and shows no flow on Doppler interrogation. Note mild fluid collection seen surrounding the mass. Also note marked subcutaneous oedema. Another imaging modality was employed; non contrast computed tomography and shows a lateral abdominal wall defect in the right lower internal oblique with sac containing bowel loop and omental fat. Other visualized bowel loops are normal in caliber and wall thickness.

Successful management of Gastroschisis baby at Tripura medical college and Dr. BRAM teaching hospital: a rare case report

Gastroschisis is a congenital defect of the anterior abdominal wall in which the intestines and other abdominal organs, protrude from the abdomen through a small hole. In recent years rates of Gastroschisis have been increasing. Most of cases it is an isolated defect or associated with other anomalies. Ultrasonography can detect it within 14 weeks after physiological herniation. Gastroschisis and omphalocele are two defect that closely resemble each other. In this case, we discuss a newborn baby with gastroschisis being successfully managed and was discharged in healthy condition 21days later.

Omphalocele and gastroschisis: An analysis of prenatal diagnosis and neonatal outcomes

AbstractBackgroundOmphalocele and gastroschisis are the most frequent congenital developmental abdominal wall defects. Prenatal diagnosis of omphalocele and gastroschisis is critical in the management of the pregnancy, affording patients the option of termination. This study aims to evaluate the prenatal diagnosis and postnatal outcomes of omphalocele and gastroschisis cases.Materials and MethodsThe cases of gastroschisis and omphalocele diagnosed prenatally and followed up at our university were evaluated retrospectively between January 2019 and January 2022. Maternal demographic and clinical characteristics and perinatal outcomes were compared between the cases.ResultsThis study evaluated 42 omphalocele and nine gastroschisis cases. All gastroschisis cases were isolated (p = .001). Additional anomalies were present in 61.9% of omphalocele cases. While two patients with gastroschisis refused the invasive procedure, the genetic results of the others were normal. The karyotype was abnormal in 42.9% of omphalocele cases (p = .008). Half of the omphalocele cases were terminated, and 38.1% (n = 8) of the terminated omphalocele cases were trisomy 18. The coexistence of multiple system anomalies and cystic hygroma was high in the terminated cases. In all cases of gastroschisis, only the intestines protruded from the abdominal wall into the amniotic fluid. The number of survivors of omphalocele was 23.8%. The median hospital stay was 25 and 14 days for gastroschisis and omphalocele, respectively.ConclusionPrenatal diagnosis of omphalocele and gastroschisis is critical in pregnancy management. The presence of associated anomalies determines the prognosis of omphalocele and gastroschisis.

MORPHOLOGICAL FEATURES OF THE REPARATIVE PROCESS IN THE PLASTIC SECTION OF THE MUSCLE-APONEUROTIC DEFECT IN THE EXPERIMENT USING STEM CELLS

Abstract. Anterior abdominal wall hernia repair is one of the most common procedures in general surgery. Very often, the parameters of the quality of life of operated patients with ventral hernias of the anterior abdominal wall during the fi rst year after the operation, according to a number of criteria, are signifi cantly better with alloplastic with polypropylene mesh, in contrast to the use of hernioplasty with the use of inert suture material. Hernias of the anterior abdominal wall (ventral hernias) most often occur after surgical intervention on the organs of the abdominal cavity and are considered postoperative complications arising in anatomically weak areas and under the infl uence of mechanical factors. The goal of the work. To experimentally investigate the eff ect of mesenchymal stem cells on the regeneration of muscle fi bers and their reparative properties in the area of postoperative wounds. When modeling a muscle- aponeurotic defect of the anterior abdominal wall with plasticity with own tissues and plasticity with an allograft in combination with injections of mesenchymal stem cells. The study was conducted on 38 white rats of both sexes, the initial weight of each animal was 215±12 g, the experimental animals were kept in the same conditions with full compliance with bioethical norms. All animals of groups 1 and 2 were experimentally modeled a muscle- aponeurotic defect of the anterior abdominal wall by an acute method up to 2.5 cm in diameter, followed by layer-by-layer suturing of this defect with a continuous wraparound single-row suture, «Vicryl» 3/0 with a barb was used as suture material with a needle In the 2nd group, plastic surgery was performed using the «on lay» technique with polypropylene mesh and suture material «Vicryl» 3/0 with a barbed needle, and mesenchymal stem cell injections were additionally performed. At the plastic site of the muscle- aponeurotic defect, the tissue of the anterior abdominal wall was taken in full layers for further histological examination. Histological examination of the wound tissues of animals of the control group 10 days after surgery showed that the wound defect was fi lled with granulation tissue at an early stage of maturation. After 30 days, the wound defect was fi lled with young loose connective tissue, in which there were sporadic islands of granulation tissue. In the area of the wound defect of 2 groups of experimental animals, after 10 days we detected maturing granulation tissue. Visually, the area of the lesion itself decreased. On the 30th day of the study, there was no granulation tissue, the wound defect was fi lled with fully matured newly formed and vascularized connective tissue. During the histological examination, it was found that as a result of the combined use of polypropylene mesh and stem cells, the regeneration of the wound defect is intensifi ed and its healing is accelerated.

Large Abdominal wall Defect with Darning Repair: A Case Series

Large Abdominal wall Defect with Darning Repair: A Case Series

Early outcomes of open anterior versus posterior components separation with transversus abdominis release for large median incisional hernias: a retrospective stepwise analysis.

Complex incisional hernia is still a debatable topic, with increasing incidence and an increased local and systemic postoperative morbidity and mortality. The size of the defect is a risk factor for both difficult closure and 30-day readmission due to complications. The main option for closure such defect is a mesh augmented component separation technique. The goal was to evaluate 30-day wound events and general complications including 90days mortality. We present a retrospective study that includes patients from two different university hospitals who underwent open incisional hernia repair with anterior component or posterior component separation between January 2015 and December 2021. Only non-contaminated adult patients (over 18years old) with postoperative primary or recurrent median abdominal wall defects larger than 6cm and with complete fascial closure were included. Demographics (age, gender, Body Mass Index-BMI, American Society of Anesthesiologists Classification-ASA score), recurrence rank, and co-morbidities), operative details, patient outcomes complications were collected. A native abdomen/pelvis computerized tomography (CT) scan was performed preoperatively in all patients and the anatomy of the defect and volumetry (abdominal cavity volume, incisional hernia volume and peritoneal volume) were evaluated. One of the component separation technique was performed according to Carbonell's equation. Two hundred and two patients (101 from each group) were included. The patients with posterior component separation were more comorbid and with larger defects. The procedure was longer with 80min but overall length of hospital stay shorter (p < 0.001) for posterior component separation. Seroma, hematoma and skin necrosis were equally distributed for both group of patients and there was no direct relation to surgery (OR 0.887, 95% CI 0.370-2.125, p = 0.788; OR 1.50, 95% CI 0.677-3.33, p = 0.318 and OR 0.386, 95% CI 0.117-1.276, p = 0.119). Surgical Site Infection rate was increased for anterior component separation (p =0.004). Complex incisional hernia repair is a challenge given by a large amount of wound complications. Choosing between anterior and posterior component separation is still a source of significant debate. We were not able to depict significant different rates of complications between the procedures and we couldn't find any specific factor related to complications.

Primary signet ring cell adenocarcinoma arising in exstrophy of the urinary bladder (epispadias-exstrophy complex).

Bladder exstrophy is a rare congenital anomaly in which the urinary bladder develops outside the body. It may be part of the bladder epispadias-exstrophy-cloacal complex, which is a serious embryological defect where a spectrum of abnormalities involving the urinary tract, genital tract, musculoskeletal system, and intestinal tract is seen. Primary signet ring cell adenocarcinoma (PSRCA) arising in exstrophy of the urinary bladder is extremely rare with only a few cases reported in the literature. A 32-year-old man with congenital, untreated bladder exstrophy presented with a large fungating mass on the lower abdominal wall. Physical examination revealed a 15 × 12 cm exophytic mass with a penile epispadias. Ultrasonography showed a replacement of the urinary bladder by a mass of size 9 × 8 × 7 cm with a defect in the abdominal wall. On Contrast-enhanced computed tomography (CECT), a mass protruding from a large, inferior abdominal wall defect of 5.3 cm was seen. Widened pubic symphysis with divarication of recti and an absent urinary bladder, consistent with bladder exstrophy, was also noted. The biopsy showed a signet ring cell adenocarcinoma. A radical cystectomy with ileal conduit and left inguinal lymph node dissection was done. Histopathology examination revealed a PSRCA with metastasis to the left inguinal lymph nodes. Immunohistochemistry (IHC) showed strong positivity with CDX2 and CK20 while CK7 was negative. PSRCA shows an aggressive behavior, as was seen in our case, which had metastatic inguinal lymph nodes at the time of presentation. Metastatic signet ring cell adenocarcinomas from other sites need to be ruled out. Bladder exstrophy can develop high-grade malignancies at any stage of life. Hence, surgical treatment early in life with lifelong follow-up is recommended.

The correlation with abnormal fetal outcome and a high level of amniotic fluid alpha-fetoprotein in mid-trimester

ObjectiveTo evaluate the correlation of high levels [>2.0 multiples of median (MoM)] of amniotic fluid alpha-fetoprotein (AFAFP) in midtrimester with abnormal fetal outcome. Materials and methodsWe retrospectively studied 6245 pregnant women with singleton pregnancy who had undergone amniocentesis between 15 and 27 weeks’ gestation at Mackay Memorial Hospital between January 2014 and June 2020. Fifty-five cases had high AFAFP levels (>2.0 MoM). We investigated the abnormal fetal outcomes. ResultsAmong the fifty-five cases with high AFAFP levels (>2.0 MoM), thirty (54.5%) had fetal chromosomal abnormalities, major structural abnormalities, and/or adverse obstetric events. Eight cases (14.5%) had chromosomal abnormalities including trisomy 21 (3 cases), trisomy 18 (3 cases), mosaic trisomy 18 (1 cases), and mosaic ring 13 (1 case). Seventeen cases (30.9%) had major structural abnormalities including abdominal wall defect (6 cases) and central nervous system (5 cases), gastrointestinal tract (3 cases), cardiovascular (2 cases), and genitourinary tract (2 cases) abnormalities. Fifteen cases (27%) had adverse obstetric events, including preterm delivery (5 cases), intrauterine fetal demise (4 cases), small for gestational age (4 cases), preeclampsia (4 cases), gestational diabetes mellitus (2 cases), gestational hypertension (1 case), preterm prelabor rupture of membrane (1 case), prolonged labor (1 case), and preterm uterine contraction (1 case). ConclusionA high AFAFP level (>2.0 MoM) in midtrimester can be associated with abnormal fetal outcome, including chromosomal abnormalities, major structural abnormalities, and adverse obstetric events. Women with a prenatal diagnosis of high AFAFP levels (>2.0 MoM) should be alerted of the possibility of abnormal fetal outcomes, and further detailed genetic studies and serial sonographic examinations are recommended.

A23Wrapping a gastroschisis baby: an MDT simulation programme

Gastroschisis is a congenital defect of the anterior abdominal wall characterized by the herniation of abdominal contents through a defect usually located to the right-side of the umbilical cord [1]. Team-working, collaboration and clear communication between the obstetric, neonatal, and paediatric surgical teams are critical to achieving optimal outcomes in gastrochisis [2]. A national cohort study of all surgical units in the UK and Ireland identified primary closure as the optimal surgical management for antenatally detected cases of simple gastroschisis [3]. A local retrospective audit in RBHSC identified a higher rate of staged gastroschisis repair in the last 10 years with 66% of patients requiring initial silo placement, when compared to 45% national average. Data also demonstrated that patient with silo placement took longer to achieve full feeds, prolonged TPN, delayed discharge, and increased complications rates. To create an interprofessional simulation programme for the preparation and management of a gastroschisis delivery, resuscitation, and initial stabilization. Aims of this project are to improve awareness of optimal stabilization management, efficiency of bowel wrapping and clear communication amongst the MDT with the overall goal of improving the rate of primary closure and outcomes in our unit. A gastroschisis simulation model was created using vegan-sausage casings, jelly, and food colouring to create the bowel. The simulation programme focused on; team education of optimal gastroschisis management, team and delivery room preparation, primary resuscitation and bowel wrapping with clingfilm. Following a lecture of gastroschisis management and demonstration of delivery room stabilization participants were divided into teams of five, given a scenario, asked to prepare equipment, allocate roles and work in sync to achieve effective resuscitation and stabilization of the new-born. Pre and Post simulation feedback was collected and course adapted using a PDSA cycle. For continued learning a post-course video for delivery room management of gastroschisis was created and available for everyone to reference at any time in any location. Pre-simulation: 56% of participants had no previous training or clinical experience of the management of gastroschisis and 78% didn’t feel confident in providing delivery suite management and stabilization. 100% of attendees felt the simulation training improved their confidence of initial management and stabilization of gastroschisis and all would recommend this course to their peers. Simulation-based interdisciplinary team training can serve as a channel for the acquisition and maintenance of clinical skills. It is crucial to improving the management of complex neonatal conditions. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Intra-abdominal pressure increases peri-operatively in patients undergoing deep inferior epigastric perforator flap reconstruction: A prospective study linking high intra-abdominal pressure to non-fatal lung embolism within one patient

The deep inferior epigastric perforator (DIEP) flap is the gold standard for autologous breast reconstruction. The procedure and peri-operative period are associated with the risk of severe post-operative complications, like venous thromboembolic events (VTE) and lung embolism. Whether the intra-abdominal pressure (IAP) increases after the closure of the abdominal defect, thereby potentially affecting the venous backflow and the risk of VTE, is currently not known. The primary aim is to test if the closure of the abdominal donor site increases the IAP in women undergoing secondary DIEP flap breast reconstruction. By using a Unometer, we measured the intravesical pressure as a surrogate marker for the IAP, at baseline, immediately after, and 24h after abdominal skin closure, for 13 patients. The mean IAP increased from 6.1mmHg (95% CI 4.6-7.7) at baseline to 9.0mmHg (95% CI 8.0-10.0) immediately after skin closure [mean diff. 2.9 (95% CI 1.0-4.8) (p=0.007)] and further up to 11.7mmHg (95% CI 9.0-14.5) 24h after closure [mean diff. 5.3 (95% CI 1.4-9.1) (p=0.012)]. We found that IAP varies among the patients, regardless of the tightness of abdominal closure or rectus plication (n=3). Immediately after closure, none of the isolated patients showed abnormal levels of IAP (>12mmHg), while eight out of 12 isolated patients (67%) showed IAP levels above the normal range after 24h. One patient developed a non-fatal lung embolism. The mean IAP increases significantly over the post-operative period after DIEP flap reconstruction, although abnormal IAP values are only seen 24h after the closure of the skin.

A case of omphalocele associated with teratoma in a new born baby: a very rare case report

An omphalocele is a congenital midline abdominal wall defect at the level of the umbilical cord insertion into the fetal abdomen that results in herniation of intra-abdominal contents into a sac comprising of an outer layer of amnion and an inner layer of peritoneum. The most common eviscerated contents are liver and small intestine though virtually any organ can be seen within the omphalocele sac including colon, pancreas, spleen, omentum, stomach, heart or genitalia. We report an unusual case of omphalocele associated with mature teratoma in Tripura medical college and DR. BRAM teaching hospital. Only five cases of teratoma arising in a case of omphalocele are reported in the literature reviewed.

Enhancing Omphalocele Care: Navigating Complications and Innovative Treatment Approaches.

Congenital abdominal wall abnormalities in infants present an interesting and difficult management problem for surgeons. Congenital malformations of the ventral abdominal wall can be diagnosed by their distinctive anatomical presentations. Among them, omphalocele, gastroschisis and umbilical cord hernias are the most frequently observed clinically detected abdominal wall anomalies. Omphalocelerefers to the herniation of abdominal contents through a defect in the abdominal wall at the umbilicus with or without the presence of a sac. This article gives an insight into the embryology, risk factors, treatment, investigations and complications of omphalocele, a common congenital abdominal wall defect. There is minimal proof that environmental factors contribute to the development of omphalocele. However, there is a considerable amount of evidence which points to the importance of genetic or familial risk factors. Newborns and infants with prenatal diagnoses are the most frequently presenting patients with omphalocele to paediatric surgeons. This article describes the problems and the steps of managementfor handling each circumstance, as well as any further complications. Omphalocele and gastroschisis are frequently described together in many research papers. However, it's crucial to considerthat they are two different conditions which vary in anatomy, pathologyand associated conditionswhich account for the difference in their treatments and noticeably varied outcomes. Additionally, there is evidence that each has a different set of factors associated with risk for occurrence. There are no known etiologic causes that cause these abnormalities to develop. The size of the baby, the extent of the lesion, and any other disorders all affect how individuals with these congenital abdominal wall anomalies are treated.

Three-Year Post-Neonatal Intensive Care Unit Health Care Utilization Among Infants with Congenital Anomalies

ObjectiveTo describe three-year post-NICU healthcare utilization among children with congenital anomalies discharged home from a level IV NICU Study DesignRetrospective chart review of children with congenital anomalies enrolled in a prior prospective cohort study from 2016-2020. We assessed hospital readmission rate, number of surgeries, and durable medical equipment (DME) use by type of anomaly. ResultsAmong 166 infants enrolled in the original study, 158 survived to NICU discharge. One-third of the cohort had a genetic anomaly. Six out of 158 patients (4%) died before age three. More than half the children were readmitted within the first two years of life and a third were readmitted in the third year of life. Readmissions were highest for those with multiple, musculoskeletal (MSK), and central nervous system (CNS) anomalies, and lowest for abdominal wall defects. About half the children underwent surgeries and this proportion remained constant over the 3-year time. Sixty-two percent of patients received DME at discharge, with gastrostomy tubes (G-tubes) being the most common. G-tubes were still present in 75% of the patients at three years of age. ConclusionChildren with congenital anomalies are at risk for increased healthcare utilization during early childhood. Those with multiple anomalies, a genetic syndrome, MSK, and CNS anomalies and those discharged with DME are at highest risk while those with abdominal wall defects are at lowest risk. Provider awareness, high-quality discharge training, parent psychological support, greater assimilation of families in the NICU, and telehealth may be some strategies to better support these families.

Longitudinal growth of children born with gastroschisis or omphalocele

Normal childhood growth is an indicator of good health, but data addressing the growth of children born with abdominal wall defects (AWDs) are limited. The detailed growth phenotypes of children born with gastroschisis or omphalocele are described and compared to peers without AWDs from birth to adolescence. Data from 183 gastroschisis and 144 omphalocele patients born between 1993 and 2017 were gathered from Finnish nationwide registers and electronic health records. Weight (n = 3033), length/height (n = 2034), weight-for-length (0–24 months, n = 909), and body mass index measures (2–15 years, n = 423) were converted into sex- and age-specific Z-scores. Linear mixed models were used for comparisons. Intrauterine growth failure was common in infants with gastroschisis. Birth weight Z-scores in girls and boys were − 1.2 (0.2) and − 1.3 (0.2) and length Z-scores − 0.7 (0.2) and − 1.0 (0.2), respectively (p < 0.001 for all comparisons to infants without AWDs). During early infancy, growth failure increased in infants with gastroschisis, and thereafter, catch-up growth was prominent and faster in girls than in boys. Gastroschisis children gained weight and reached their peers’ weights permanently at 5 to 10 years. By 15 years or older, 30% of gastroschisis patients were overweight. Infants with omphalocele were born with a normal birth size but grew shorter and weighing less than the reference population until the teen-age years.Conclusion: Children with gastroschisis and omphalocele have distinct growth patterns from fetal life onwards. These growth trajectories may also provide some opportunities to modulate adult health.What is Known:• Intrauterine and postnatal growth failure can be seen frequently in gastroschisis and they often show significant catch-up growth later in infancy. It is assumed that part of the children with gastroschisis will become overweight during later childhood.What is New: • The longitudinal growth of girls and boys with gastroschisis or omphalocele is described separately until the teenage years. The risk of gaining excessive weight in puberty was confirmed in girls with gastroschisis.

EP10.11: Pitfalls in growth assessment and prenatal surveillance in fetuses with abdominal wall defects

EP10.11: Pitfalls in growth assessment and prenatal surveillance in fetuses with abdominal wall defects

Killing two birds with one stone: A therapeutic copper-loaded bio-patch promoted abdominal wall repair via VEGF pathway.

Hernia and life-threatening intestinal obstruction often result from abdominal wall injuries, and the regeneration of abdominal wall defects is limited due to the lack of biocompatible, antibacterial and angiogenic scaffolding materials for treating injured tissues. Taking inspiration from the facile preparation of dopamine polymerization and its surface modification technology, in this study, multi-therapeutic copper element was introduced into porcine small intestinal submucosa (SIS) bio-patches through polydopamine (PDA) deposition, in order to regenerate abdominal wall injury. In both in vitro antibacterial assays, cytocompatibility assays and in vivo abdominal wall repair experiments, the SIS/PDA/Cu bio-patches exhibited robust antibacterial efficiency (＞99%), excellent biocompatibility to cells (＞90%), and enhanced neovascularization and improved collagen maturity compared to other commercially available patches (3.0-fold higher than the PP mesh), due to their activation of VEGF pathway. These findings indicated the bio-patch was a promising application for preventing visceral adhesion, bacterial infection, and promoting soft tissue regeneration.