Location
Suwanee, GA
Start Date
7-5-2024 1:00 PM
End Date
7-5-2024 4:00 PM
Description
Introduction: Traditionally, surgical management of gastroschisis involved a primary or staged reduction of the viscera followed by sutured defect closure. Over the past 20 years, the plastic sutureless closure technique has gained popularity where the defect is covered with a remnant of the umbilical cord and a plastic dressing. However, little investigation has been done to compare the postoperative complications associated with sutured and sutureless techniques. We hypothesize that sutured closures will have a greater complication rate than sutureless closures.
Methods: A search of primary literature was conducted in PubMed, Embase and Cochrane databases using PRISMA criteria in February 2024 the keywords “gastroschisis” and “wound closure” and “complication” with results limited to the years 2004-2024. Statistical analysis was achieved using a Chi square test.
Results: Our initial search yielded 534 articles across all three databases, which was narrowed to 358 after the initial search criteria were applied and 332 after duplicates were removed. 30 studies were found to meet the inclusion criteria for this study and included a total of 1015 patients (sutured, n=870; sutureless, n=145). Total number of complications was 14.71% (n=128) for patients in the sutured group and 26.90% (n=39) for patients in the sutureless group. There was a significant increase in the total number of complications in the sutureless group compared to the sutured group (p<0.05). Complications included compartment syndrome, small bowel obstruction, surgical site infection, umbilical hernia, necrotizing enterocolitis, sepsis, death, and ileus.
Conclusion: This review supports the hypothesis that sutured closure of gastroschisis has fewer complications than sutureless closures. While this doesn’t support our initial hypothesis, this could be due to the disproportionate number of patients included in the sutureless group compared to the sutured group. It is also possible that the complications in the sutureless group may have been exacerbated by the closure’s reduced strength. Further research should be performed to better evaluate the differences in specific complications between patients undergoing sutured vs. sutureless gastroschisis closure.
Embargo Period
7-2-2024
Included in
Meta-analysis of Complications Associated with Sutured vs. Sutureless Primary Gastroschisis Closing
Suwanee, GA
Introduction: Traditionally, surgical management of gastroschisis involved a primary or staged reduction of the viscera followed by sutured defect closure. Over the past 20 years, the plastic sutureless closure technique has gained popularity where the defect is covered with a remnant of the umbilical cord and a plastic dressing. However, little investigation has been done to compare the postoperative complications associated with sutured and sutureless techniques. We hypothesize that sutured closures will have a greater complication rate than sutureless closures.
Methods: A search of primary literature was conducted in PubMed, Embase and Cochrane databases using PRISMA criteria in February 2024 the keywords “gastroschisis” and “wound closure” and “complication” with results limited to the years 2004-2024. Statistical analysis was achieved using a Chi square test.
Results: Our initial search yielded 534 articles across all three databases, which was narrowed to 358 after the initial search criteria were applied and 332 after duplicates were removed. 30 studies were found to meet the inclusion criteria for this study and included a total of 1015 patients (sutured, n=870; sutureless, n=145). Total number of complications was 14.71% (n=128) for patients in the sutured group and 26.90% (n=39) for patients in the sutureless group. There was a significant increase in the total number of complications in the sutureless group compared to the sutured group (p<0.05). Complications included compartment syndrome, small bowel obstruction, surgical site infection, umbilical hernia, necrotizing enterocolitis, sepsis, death, and ileus.
Conclusion: This review supports the hypothesis that sutured closure of gastroschisis has fewer complications than sutureless closures. While this doesn’t support our initial hypothesis, this could be due to the disproportionate number of patients included in the sutureless group compared to the sutured group. It is also possible that the complications in the sutureless group may have been exacerbated by the closure’s reduced strength. Further research should be performed to better evaluate the differences in specific complications between patients undergoing sutured vs. sutureless gastroschisis closure.
Comments
Presented by Madeline Felice.