Pandey Vaibhav, Gangopadhyay A N, Gupta D K, Sharma S P, Kumar Vijayendar
Department of Paediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP, India,
Pediatr Surg Int. 2014 Apr;30(4):407-11. doi: 10.1007/s00383-014-3479-9. Epub 2014 Feb 9.
The aim of the study was to evaluate topical povidone-iodine and topical powdered antibiotic combination (Polymyxin, Bacitracin and Neomycin) in initial non-operative management with delayed closure of the defect of giant omphaloceles.
A prospective study was conducted between July 2010 and June 2013 including all neonates with giant omphalocele without signs of intestinal obstruction. All cases were managed by daily application of povidone-iodine (5% solution) followed by spraying topical powdered antibiotic combination to promote eschar formation and eventual epithelialisation. Record was made of sex, associated anomalies, length of stay, and thyroid function tests.
Twenty-four neonates with giant omphaloceles were treated with topical povidone-iodine and topical powdered antibiotic combination. No sac ruptures were observed in our series. All patients had a normal thyroid function test at presentation and after 10 days of initiation of treatment. Six patients have undergone delayed repair.
Topical povidone-iodine and powdered antibiotic combination promotes more rapid escharification and epithelialisation of the omphalocele than povidone-iodine alone. We also hypothesise that combination minimises the chances of hypothyroidism associated with use of povidone-iodine alone.
本研究旨在评估局部应用聚维酮碘与局部应用抗生素粉剂组合（多粘菌素、杆菌肽和新霉素）在巨大脐膨出缺损延迟关闭的初始非手术治疗中的效果。
2010年7月至2013年6月进行了一项前瞻性研究，纳入所有无肠梗阻迹象的巨大脐膨出新生儿。所有病例均每日应用聚维酮碘（5%溶液），随后喷洒局部抗生素粉剂组合以促进焦痂形成及最终上皮化。记录性别、相关畸形、住院时间及甲状腺功能检查结果。
24例巨大脐膨出新生儿接受了局部聚维酮碘与局部抗生素粉剂组合治疗。本系列中未观察到囊膜破裂。所有患者在就诊时及开始治疗10天后甲状腺功能检查均正常。6例患者接受了延迟修复。
局部聚维酮碘与抗生素粉剂组合比单独使用聚维酮碘能更快速地促进脐膨出焦痂形成及上皮化。我们还推测该组合可降低单独使用聚维酮碘所致甲状腺功能减退的几率。
