Routine use of a SILASTIC spring-loaded silo for infants with gastroschisis: a multicenter randomized controlled trial

Aimee C. Pastor, J. Duncan Phillips, Stephen J. Fenton, Rebecka L. Meyers, Amy W. Lamm, Mehul V Raval, Elizabeth Lehman, Tracy B. Karp, Paul W. Wales, Jacob C. Langer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

81 Scopus citations

Abstract

Background: Retrospective studies have suggested that routine use of a preformed silo for infants with gastroschisis may be associated with improved outcomes. We performed a prospective multicenter randomized controlled trial to test this hypothesis. Methods: Eligible infants were randomized to (1) routine bedside placement of a preformed Silastic spring-loaded silo, with gradual reduction and elective abdominal wall closure, or (2) primary closure. Results: There were 27 infants in each group. There was no significant difference between groups with respect to age, weight, sex, Apgar scores, prenatal diagnosis, or mode of delivery. The total number of days on the ventilator was lower in the spring-loaded silo group, although it did not reach statistical significance (3.2 vs 5.3, P = .07). There was no significant difference between groups with respect to length of time on total parenteral nutrition, length of stay, or incidence of sepsis and necrotizing enterocolitis. Conclusion: Routine use of a preformed silo was associated with similar outcomes to primary closure for infants with gastroschisis but with a strong trend toward fewer days on the ventilator. Use of a preformed silo has the advantage of permitting definitive abdominal wall closure in a more elective setting.

Original languageEnglish (US)
Pages (from-to)1807-1812
Number of pages6
JournalJournal of pediatric surgery
Volume43
Issue number10
DOIs
StatePublished - Oct 2008

Keywords

  • Abdominal wall defects
  • Intraabdominal pressure
  • Spring-loaded silo

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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