Use of Cryopreserved Human Umbilical Cord and Amniotic Membrane Allograft and Portable Negative Pressure Therapy in Dehisced Giant Omphalocele Repair: A Case Study.

BACKGROUND

A giant omphalocele is a rare congenital abdominal wall defect that measures more than 6 to 8 cm in any dimension. The child's abdominal visceral contents as well as the liver which are both covered by the amniotic sac protrude outside the abdomen through the umbilicus. Consequently, closing this defect is extremely challenging due to the risk for wound dehiscence.

CASE

Baby C, a 1-year-old male infant, developed a dehisced abdominal wound after secondary repair of a giant omphalocele. Escharification of the amniotic sac was achieved with silver products, followed by intra-abdominal tissue expansion and skin closure. A conservative approach was undertaken with the use of cryopreserved human umbilical cord and amniotic membrane allograft in conjunction with portable negative pressure therapy.

CONCLUSIONS

To the best of our knowledge, this is the first case study to evaluate the effect of cryopreserved human umbilical cord and amniotic membrane allograft in a dehisced neonatal abdominal wound due to a giant omphalocele or, in fact, neonatal wounds in general. Our experience with this case suggests that cryopreserved human umbilical cord and amniotic membrane allograft may create a superior healing trajectory and regeneration, avoidance of surgical intervention, and an early hospital discharge. Wound-supporting properties of amniotic allograft, in addition to lack of immunologic reactivity, offer an attractive option for a variety of pediatric and neonatal wounds.