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A risk-stratified comparison of fascial versus flap closure techniques on the early outcomes of infants with gastroschisis
- Source :
- Journal of pediatric surgery. 50(1)
- Publication Year :
- 2014
-
Abstract
- Background While fascial closure is traditionally used in gastroschisis (GS), flap closure (skin or umbilical cord) has gained popularity. We evaluated early outcomes and complications of the two techniques. Methods A national, population-based gastroschisis data registry was analyzed from 2005 to 2011. We compared fascial to flap closures and stratified patients into low or high-risk groups using the Gastroschisis Prognostic Score (GPS), a validated marker of post-natal bowel injury. Demographic and outcome data, including length of stay, complications, and markers of resource utilization were analyzed using Fisher’s exact and Student’s t-tests for categorical and continuous variables, respectively (p Results The analyzed dataset included 436 fascial closures (344 [78.8%] low-risk, 92 high-risk) and 129 flap closures (112 [86.7%] low-risk, 17 high-risk; p=0.06). Demographics and birth weight did not differ between groups. In patients with low GPS, flap closure demonstrated significant decreases in resource utilization and failure of closure, without differences in complication rates. Analysis of high-risk patients revealed no statistically significant differences in outcome. Conclusion Flap closure was not associated with an increase in patient morbidity and seemed suitable as a definitive closure method for gastroschisis patients irrespective of disease severity. Furthermore, flap closure reduced several markers of resource utilization in patients with low-risk disease.
- Subjects :
- Male
Risk
medicine.medical_specialty
Birth weight
Population
Umbilical cord
Risk Assessment
Surgical Flaps
Continuous variable
Disease severity
medicine
Birth Weight
Humans
In patient
education
Gastroschisis
education.field_of_study
business.industry
Wound Closure Techniques
Infant
General Medicine
Length of Stay
medicine.disease
Surgery
Fasciotomy
medicine.anatomical_structure
Anesthesia
Pediatrics, Perinatology and Child Health
Female
Complication
business
Subjects
Details
- ISSN :
- 15315037
- Volume :
- 50
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of pediatric surgery
- Accession number :
- edsair.doi.dedup.....e91664d181feba5b42ba6139482d575c