TY - JOUR T1 - Use of a neoprene binding to reduce giant omphaloceles followed by delayed closure JF - World Journal of Pediatric Surgery JO - World Jnl Ped Surgery DO - 10.1136/wjps-2021-000284 VL - 4 IS - 4 SP - e000284 AU - Barbara Lelj-Garolla AU - Lorena Campbell AU - Jaideep Kanungo AU - Naomi Yoshida Y1 - 2021/09/01 UR - http://wjps.bmj.com/content/4/4/e000284.abstract N2 - Omphaloceles occur in about 1 in 5000 births and are the second most common congenital abdominal wall defects.1 Repair remains a surgeon’s preference with early closure only attempted for small-to-medium omphaloceles, while delayed closure is used for giant omphaloceles.2–4 In recent years, novel techniques that aim at reducing the disproportion between the abdominal cavity and the volume of the extra-abdominal viscera have been described to manage giant omphaloceles.4–17Although less commonly associated with genetic abnormalities, giant omphaloceles are associated with adverse neurodevelopmental outcome at 2 years.18 In addition to gestational age, birth weight, associated malformation, resuscitation and hypoxia, other factors including prolonged stay in the neonatal intensive care unit (NICU), time on ventilation, infections, and delayed establishment of enteral nutrition are likely contributory factors.19This is a case study of two infants with giant omphaloceles treated in our institution with a novel neoprene binder preoperatively. The binder allows for gradual reduction of the viscera below the level of the skin followed by early fascia closure. Families were contacted for a follow-up survey about parental experience and satisfaction in March–July 2020. A summary of the demographic and outcomes is reported in table 1.View this table:In this windowIn a new windowTable 1 Summary of patient’s demographic and outcomesBoth infants had giant omphaloceles2 3 larger than 5 cm with most of the liver and bowel in the sac. Neither had other major abnormalities nor genetic disorders. After delivery, infants were wrapped in a plastic bag to protect the omphalocele sac and were transferred to NICU for initial care. Infants did not require sedation or intubation, and enteral feeds were started on day 1 of life, with 5 and 11 days, respectively, of concomitant parenteral nutrition until full enteral feeds were established. Immediately postnatally, the intact sac was cleaned and dressed with Restore silver dressing … ER -