PMC7738231_01
Giant gastroschisis (
A
) after delivery, (
B
) after positioning of the wound retractor under the fascia, (
C
) secondary closure of the abdominal cavity using a bovine xenograft on day of life 10, and (
D
) follow-up at the age of 14 months.
10-1055-s-0040-1721054-i200554cr-1.jpg
PMC7738231_01_10-1055-s-0040-1721054-i200554cr-1.jpg
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At birth, a fascial defect to the right of the umbilical cord (gastroschisis) with prolapse of intestine, stomach, spleen, and liver was seen ( Fig. 1A ). After delivery, a wound retractor (Alexis wound retractor, size XS, Applied Medical) was positioned under the fascia as a silo and the intestines reduced into the abdomen ( Fig. 1B ). On day of life (DOL) 10, we performed a secondary closure of the fascial defect (6 cm) using a xenograft (bovine dermis, SurgiMed collagen matrix, 2 mm thickness; Fig. 1C ) and applied a vacuum assisted closure-dressing for 10 days. The xenograft was completely covered with skin at the age of 14 months ( Fig. 1D ).
PMC7738231_02
Ruptured giant omphalocele (
A
) after delivery, (
B
) application of a wound retractor, (
C
) after staged reduction, and (
D
) secondary closure of the abdominal fascia on day of life 12.
10-1055-s-0040-1721054-i200554cr-2.jpg
PMC7738231_02_10-1055-s-0040-1721054-i200554cr-2.jpg
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The omphalocele sac ruptured during surgical delivery, which was challenging due to severe obesity of the mother ( Fig. 2A ). Postnatally and under general anesthesia, a wound retractor (Alexis wound retractor, size S, Applied Medical) was placed under the fascia as a silo for staged reduction ( Fig. 2B ). During the following days, it was possible to slowly reduce the liver into the abdominal cavity ( Fig. 2C ). On DOL 12 secondary closure of the abdominal wall including the fascia was performed ( Fig. 2D ).