Mar 20, 2012

Delayed management of giant omphalocele using silver sulfadiazine cream: an 18-year experience

Journal of Pediatric Surgery
Sigmund H Ein, Jacob C Langer

Abstract

To assess the value of topical silver sulfadiazine (SSD) cream in the treatment of babies with a giant omphalocele. From 1991 to 2008 inclusive, 20 infants with giant omphalocele (defined as >10 cm diameter) were treated with SSD, leaving a large ventral hernia to be repaired at a later date. There were 12 boys and 8 girls. Thirteen had prenatal ultrasound diagnosis at a mean gestational age of 23 weeks. The mean gestational age at delivery was 37 weeks, and mean birth weight was 2.5 kg. Nineteen had other anomalies and/or medical problems, 18 of them multiple. The most common was pulmonary hypoplasia (70%). Mechanical ventilation and/or oxygen treatment was required in 15 (75%) for a mean of 10 weeks. SSD was used as primary sac treatment in 5 and secondary treatment in 15 (after Silon pouch 11, Op-site 3, povidone-iodine 1). Six omphalocele sacs were ruptured within the first 5 days of life. SSD was used for a mean of 6 months at a cost of $1 per day. Complications included 2 instances of staphylococcal sepsis and 1 jejunal perforation inside a Silon pouch. Six (30%) died from pulmonary hypoplasia at a mean age of 18 weeks. There were 14 (70%) survivors who went home after a mean of 14 weeks. Of the 14 survivors, 12 had ventr...Continue Reading

  • References20
  • Citations15

References

  • References20
  • Citations15

Mentioned in this Paper

Entire Abdominal Wall
Congenital Structural Myopathy
Dermazin
Abdominal Cavity
Nephrotic Syndrome
Congenital Neurologic Anomalies
Herniorrhaphy
Opitz-G Syndrome, Type 2
Spastic Paraplegia 17
Silon

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