From the Research
Omphalocele Repair Timing
- Omphalocele repair can occur immediately after birth, as shown in a study where immediate repair significantly improved short-term neonatal outcomes compared to delayed repair 1.
- Delayed repair can also be an option, with one study finding that delayed closure was associated with good outcomes in patients with giant omphaloceles, with a median age at repair of 10 months 2.
- Staged repair is another approach, which can be necessary for giant omphaloceles that cannot be closed primarily, and may involve the use of a silo or tissue expansion 3, 4.
- The timing of repair may depend on the size of the omphalocele, with smaller omphaloceles potentially being closed primarily and earlier, while larger ones may require staged repair or delayed closure 2, 4.
Factors Influencing Repair Timing
- The presence of associated anomalies is a strong predictor of morbidity and mortality in fetuses or neonates with omphalocele, and may influence the timing of repair 2.
- The size of the omphalocele, with giant omphaloceles potentially requiring staged repair or delayed closure, can also impact the timing of repair 2, 3.
- The use of adjuncts to abdominal wall reconstruction, such as tissue expansion and mesh, may also influence the timing of repair 4.
Repair Techniques
- Immediate repair can involve primary fascial repair for small omphaloceles 1.
- Staged repair can involve the use of a silo, tissue expansion, or other techniques to facilitate closure 3, 4.
- Negative pressure wound therapy (NPWT) can also be used as an effective method for giant omphalocele repair, particularly when combined with new wound dressings 5.