Outcomes of bedside sutureless umbilical closure without endotracheal intubation for gastroschisis repair in surgical infants

Gillian E. Pet, Rebecca Stark, John J. Meehan, Patrick J. Javid

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Introduction Newborns with gastroschisis have historically undergone surgical repair under general anesthesia. Our institution recently transitioned to the sutureless umbilical closure for gastroschisis. We sought to evaluate the feasibility of bedside gastroschisis repair without endotracheal intubation. Methods A retrospective review was performed of neonates with gastroschisis who underwent sutureless umbilical closure from 2011 to 2015. Clinical characteristics and outcomes between groups were compared. Results In total, 53 infants underwent sutureless umbilical closure. Closure without endotracheal intubation was attempted in 23 (43%) babies and was successful in 15 (65%) infants. Two of the 8 patients who required intubation needed a temporary silo. Neonates successfully repaired without intubation were more premature (p < 0.01), smaller at birth (p = 0.01), and repaired nearly an hour sooner (p < 0.01). There were no differences in time to full enteral nutrition, length of stay, bowel ischemia, or sepsis. Conclusion Bedside sutureless umbilical closure without intubation is feasible and effective in newborns with gastroschisis. The procedure decreases time to gastroschisis closure. Smaller and more premature neonates were more likely to be successfully closed without intubation.

Original languageEnglish (US)
Pages (from-to)958-962
Number of pages5
JournalAmerican Journal of Surgery
Volume213
Issue number5
DOIs
StatePublished - May 1 2017

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Gastroschisis
Umbilicus
Intratracheal Intubation
Intubation
Newborn Infant
Enteral Nutrition
General Anesthesia
Length of Stay
Sepsis
Ischemia
Parturition

ASJC Scopus subject areas

  • Surgery

Cite this

Outcomes of bedside sutureless umbilical closure without endotracheal intubation for gastroschisis repair in surgical infants. / Pet, Gillian E.; Stark, Rebecca; Meehan, John J.; Javid, Patrick J.

In: American Journal of Surgery, Vol. 213, No. 5, 01.05.2017, p. 958-962.

Research output: Contribution to journalArticle

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N2 - Introduction Newborns with gastroschisis have historically undergone surgical repair under general anesthesia. Our institution recently transitioned to the sutureless umbilical closure for gastroschisis. We sought to evaluate the feasibility of bedside gastroschisis repair without endotracheal intubation. Methods A retrospective review was performed of neonates with gastroschisis who underwent sutureless umbilical closure from 2011 to 2015. Clinical characteristics and outcomes between groups were compared. Results In total, 53 infants underwent sutureless umbilical closure. Closure without endotracheal intubation was attempted in 23 (43%) babies and was successful in 15 (65%) infants. Two of the 8 patients who required intubation needed a temporary silo. Neonates successfully repaired without intubation were more premature (p < 0.01), smaller at birth (p = 0.01), and repaired nearly an hour sooner (p < 0.01). There were no differences in time to full enteral nutrition, length of stay, bowel ischemia, or sepsis. Conclusion Bedside sutureless umbilical closure without intubation is feasible and effective in newborns with gastroschisis. The procedure decreases time to gastroschisis closure. Smaller and more premature neonates were more likely to be successfully closed without intubation.

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