SILON AS A SAC IN TREATMENT OF OMPHALOCELE AND GASTROSCHISIS

Four babies with prenatal exposed intestines were treated by creating a temporary sac made from dacron coated with Silastic. This material can be sutured to the fascia of the abdominal wall but at the present time it seems advisable to simply suture the prosthesis to the full thickness of the abdominal wall with no preliminary dissection. The use of gamma globulin, systemic and local antibiotics, and strict sterile precautions in the postoperative period diminish the risk of infection which accounted for one death in the series. The gradual reduction of the viscera by simple compression and ligation of the distal portion of the sac avoids the complications associated with abdominal crowding and seems to allow for earlier normal intestinal alimentation. Steroids have been used, hopefully to reduce the inflammatory state of the intestinal tract allowing for earlier intestinal motility. It is important that the extruded viscera simply be covered at the time of the first operation with little or no reduction. These babies looked well in the immediate postoperative period and had no cardiopulmonary complications. The babies stooled normally by the second to fourth day, but feedings were delayed until the abdominal wall was completely closed. Growth and development have been normal in the survivors. © 1969.