Lee S C, Jung S E, Kim W K
Department of Pediatric Surgery, Seoul National University Children's Hospital, Korea.
J Pediatr Surg. 1997 Jan;32(1):66-8. doi: 10.1016/s0022-3468(97)90096-8.
Although primary repair is preferred for gastroschisis, this cannot be performed in many patients because of the visceroabdominal disproportion or other accompanying conditions. Several prosthetic materials are used for a silo or patch. When prosthetics are used, staged operations are necessary and infection is an inherent problem. However, these problems can be avoided by using Steridrape for a silo without suturing. The authors used the Steridrape to create a covering for two patients. The eviscerated bowel was irrigated and the abdominal wall was cleansed. A sheet of Steridrape was attached onto the abdominal wall and the herniated viscera was wrapped with it. A second sheet was applied over the first one. Antibiotics were administered and parenteral nutrition was started. The Steridrape covering was changed twice a week. In 1 week the edema subsided remarkably and in 2 weeks the bowel had an almost normal appearance except for hyperemic serosa. Primary repair was performed on the 19th hospital day in patient 1, the 14th day in patient 2. Oral feeding was started 7 days after repair in patient 1, and 22 days after repair in patient 2. Patient 2 developed aspiration pneumonia during transport. Discharge was on the 18th day after surgery in patient 1 and the 50th day in patient 2. The patients are now 18 months and 14 months old, respectively, and are doing well. Steridrape application in gastroschisis is economical, easy to perform, and is a better method to use when transporting the patient. It also facilitates drainage of purulent exudate, and allows the bowel to be inspected easily. This method has proved useful in treating two patients with gastroschisis.
虽然腹裂首选一期修复，但由于内脏与腹壁比例失调或其他伴随情况，许多患者无法进行一期修复。几种假体材料用于制作袋状或补片。使用假体时，需要分期手术，且感染是一个固有问题。然而，通过使用 Steridrape 制作袋状而不缝合可以避免这些问题。作者使用 Steridrape 为两名患者制作覆盖物。对脱出的肠管进行冲洗，清洁腹壁。将一片 Steridrape 贴在腹壁上，用它包裹突出的内脏。在第一片上再覆盖第二片。给予抗生素并开始肠外营养。Steridrape 覆盖物每周更换两次。1 周后水肿明显消退，2 周后除浆膜充血外，肠管外观几乎正常。患者 1 在住院第 19 天进行一期修复，患者 2 在第 14 天进行。患者 1 修复后 7 天开始经口喂养，患者 2 修复后 22 天开始。患者 2 在转运过程中发生吸入性肺炎。患者 1 术后第 18 天出院，患者 2 在第 50 天出院。这两名患者现在分别为 18 个月和 14 个月大，情况良好。在腹裂中应用 Steridrape 经济、操作简便，是转运患者时更好的方法。它还便于脓性渗出物引流，并能轻松检查肠管。该方法已被证明对治疗两名腹裂患者有用。
