Negative pressure wound therapy for initial management of giant omphalocele

BackgroundCurrent treatment of giant omphalocele includes “paint and wait” or placement of mesh or silo. These methods are associated with high complication rates. We propose negative pressure wound therapy as an alternative.MethodsPatients born between 2009 and 2014 with giant omphalocele were included. Outcomes analyzed were duration of therapy, time to full enteral feeds, treatment related complications, wound surface area over time, type, and time to definitive closure.ResultsEight patients were reviewed. The median duration of therapy was 68 days. Median time to full enteral feeds was 19 days. There were no treatment discontinuations or complications including sac ruptures, wound infections, or fistulas. Wound contraction stopped at 2 months or around 7 cm2. All surviving patients underwent definitive closure.ConclusionsNegative pressure wound therapy is a safe and effective treatment for giant omphalocele that allows feeding, has a low complication rate, and is completed in 2 months.