Department of Surgery, Delta State University, Abraka, Nigeria.
Department of Community Medicine, Delta State University, Abraka, Nigeria.
West Afr J Med. 2022 Aug 31;39(8):816-822.
Omphalocele consists of congenital malformation of anterior abdominal wall defects occurring at the midline with herniation of the viscera through this defect. Giant omphaloceles constitute a challenging situation as such conservative management has been advocated as an effective method of treatment. This study aimed to compare the conventional method of dressing the omphalocele sac using gauze, an escharotic agent, and a crepe bandage to our improvised method of the usage of a sterilization wrap over the escharotic agent with a crepe bandage.
This was a retrospective comparative review of 7 babies with giant omphalocele that was treated with topical honey and the non-adherent sterilization wrap covering (group B) and compared with 6 babies that had honey, sofratulle ,and dry gauze covering (group A) that was initially done in our center.
All of the babies who were in group B had an uneventful epithelization of the sac with no rupture; also, no death occurred in this group. However, three in group A had sacs that ruptured before epithelization. Two of these died from complications of sepsis following rupture of the sac, one had a small point on the sac which was ruptured and it healed with a dressing left in place for a week.
The use of Kimberley-Clark sterilization wrap prevents rupture of the sac while using the escharotic agent, thereby reducing mortality. We advocate that gauze should not make any contact with the omphalocele sac.
脐膨出是一种先天性腹壁中线缺陷，内脏通过该缺陷疝出。巨大脐膨出是一种具有挑战性的情况，因此保守治疗已被提倡为一种有效的治疗方法。本研究旨在比较传统的使用纱布、腐蚀剂和弹性绷带包扎脐膨出囊的方法与我们改良的使用消毒包裹腐蚀剂和弹性绷带的方法。
这是一项回顾性对比研究，纳入了 7 例接受局部蜂蜜和非粘性消毒包裹（B 组）治疗的巨大脐膨出婴儿，并与 6 例接受蜂蜜、sofratulle 和干纱布覆盖（A 组）治疗的婴儿进行比较，A 组最初在我们中心进行治疗。
B 组所有婴儿的囊袋均无破裂，顺利上皮化；该组也无死亡发生。然而，A 组有 3 例囊袋在上皮化前破裂。其中 2 例因囊破裂后的败血症并发症死亡，1 例囊上有一个小破口，用留置的敷料处理一周后愈合。
使用 Kimberly-Clark 消毒包裹可以防止腐蚀剂引起的囊破裂，从而降低死亡率。我们主张纱布不应与脐膨出囊接触。
