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Abdominal wall defects are serious birth defects, with long periods of hospitalization and significant costs to the medical system. Nosocomial infection (NI) may be an additional risk factor that aggravates the evolution of newborns with such malformations. Methods: in order to analyze the factors that may lead to the occurrence of NI, we performed a retrospective study over a period of thirty-two years (1990–2021), in a tertiary children’s hospital; 302 neonates with omphalocele and gastroschisis were eligible for the study. Results: a total of 33.7 % patients were infected with one or more of species of bacteria or fungi. These species were Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter spp., Staphylococcus spp., Enterococcus spp. or Candida spp., but the rate of NI showed a significant decrease between the 1990–2010 and 2011–2021 period (p = 0.04). The increase in the number of surgeries was associated with the increase in the number of NI both for omphalocele and gastroschisis; in the case of gastroschisis, the age of over 6 h at the time of surgery increased the risk of infection (p = 0.052, marginal statistical significance). Additionally, for gastroschisis, the risk of NI was 4.56 times higher in the presence of anemia (p < 0.01) and 2.17 times higher for the patients developing acute renal failure (p = 0.02), and a hospitalization period longer than 14 days was found to increase the risk of NI 3.46-fold (p < 0.01); more than 4 days of TPN was found to increase the NI risk 2.37-fold (p = 0.015). Using a logistic regression model for patients with omphalocele, we found an increased risk of NI for those in blood group 0 (OR = 3.8, p = 0.02), in patients with a length of hospitalization (LH) of ≥14 days (OR = 6.7, p < 0.01) and in the presence of anemia (OR = 2.5, p = 0.04); all three independent variables in our model contributed 38.7% to the risk of NI. Conclusion: although in the past 32 years we have seen transformational improvements in the outcome of abdominal wall defects, there are still many factors that require special attention for corrections.

Objective: Recently, achieving good cosmetic results for patients with gastroschisis has gained popularity, as since the visceral organs can be safely positioned into the abdominal cavity. We aimed to evaluate patient outcomes while focusing on the cosmetic results to contribute to the limited amount of data on this subject in the literature.Methods: From January 2005 to May 2018, patients operated on for gastroschisis in a single institution were evaluated retrospectively.Results: Twenty-two patients with gastroschisis were treated (10 females/12 males). The mean gestational age was 38.2±2.1 weeks. The mean birth weight was 2256.9±418.2 g. Eleven patients were diagnosed prenatally. Five patients had complex gastroschisis. Others presented with necrosis (n=3), perforation (n=3), volvulus (n=1) and jejunal atresia (n=1). Primary closure (n=16) and staged closure (n=6) were performed. Patients needed mechanical ventilation and total parenteral nutrition for 3.7±1.0 days and 24.3±9.7 days, respectively. Enteral feeding was started at 15.9±10.5 days. The duration of hospitalisation was 36.7±13.3 days. Three patients died from sepsis and multi-organ failure.Conclusion:We believe that performing appropriate gastroschisis surgery at the same hospital without transferring to another centre is the main factor in achieving a successful outcome. Good cosmetic results and visceral function were achieved in this study in 86.3% patients.

Background The present study is conducted to introduce a common disease of abdominal wall which has received less attention in scientific resources. In traditional medicine sources Some scholars believe that this condition occurs due to the movement of the abdominal muscle near the umbilicus or nave laterally movement of nave. Design A case series study. Method the study did not receive any funding. This study was a case series study. The study population was all patients who following repeated hospital visits did not improve, and for their last try, they visited a traditional clinic, and were diagnosed with umbilical hernia during a period of 5 months. Data were collected using demographic information questionnaire, and a complete health history taking. Results nave sliding is an abdominal wall defect and gastrointestinal and psychological problems are listed as the most prominent sign and symptoms. higher body mass index and presence of a first-degree relative with the same problem could be a predictor factor. Conclusion Nave sliding is a common disease that there are a few scientific literatures about it and needs more attention from clinicians to avoid false diagnoses and requires more academic research to clarify any ambiguous side about it to promote the treatment process in a more scientific and approved methods., Highlights • Nave sliding is an abdominal wall defect. • gastrointestinal and psychological problems are listed as the most prominent sign and symptoms. • Higher body mass index and presence of a first-degree relative with the same problem could be a predictor factor.

Major congenital abdominal wall defects (gastroschisis and omphalocele) may account for up to 21% of emergency neonatal interventions in low- and middle-income countries. In many low- and middle-income countries, the reported mortality of these malformations is 30–100%, while in high-income countries, mortality in infants with major abdominal wall reaches less than 5%. This review highlights the challenges faced in the management of newborns with major congenital abdominal wall defects in the resource-limited setting. Current high-income country best practice is assessed and opportunities for appropriate priority setting and collaborations to improve outcomes are discussed.

We report a very rare case of isolated thoracoschisis from the city of Campinas-Sao Paulo, Brazil. Early management in the NICU allowed gentle reduction of the viscera back to the abdominal cavity with no signs of ischemia or respiratory distress. Complete repair was performed four days later in the operating room, under general anesthesia, using a biocompatible collagen/polyester mesh. Postoperative course was uneventful, the child was discharged from hospital on the 24th postoperative day and outpatient follow-up shows a normal developing child. Clinical and surgical aspects of this rare malformation are discussed.

The testis is rarely encountered within the organs prolapsed outside the abdominal wall defect of patients with gastroschisis. Optimal treatment strategy of this unusual type of cryptorchidism remains undefined, with less than 30 cases reported to date. We describe a new case where simple relocation of the testis into the abdomen was followed by spontaneous testicular descent. Additionally, he developed a urinary calculus impacted in the navicular fossa 4 years later. Given the rarity of the 2 conditions, the probability of their co-occurrence is exceptionally rare, especially considering that they seem to be causally and temporally unrelated to one another.

Pentalogy of Cantrell (PC) is a rare congenital anomaly characterized by changes in the mesodermal median structures and congenital heart disease, often with a poor prognosis. In 1958, Cantrell et al2 defined the full spectrum of the syndrome with the following anomalies: defects of the anterior diaphragm, of the lower part of the sternum, of the supraumbilical region and the abdominal wall, of the diaphragmatic pericardium, and various intracardiac congenital abnormalities. The present report describes a case of ectopia cordis associated with PC and the importance of the participation of a multidisciplinary team in the treatment of this condition.A pentalogia de Cantrell (PC) é uma rara anomalia congênita caracterizada por alterações nas estruturas medianas mesodérmicas e doenças cardíacas congênitas, cursando muitas vezes com um mau prognóstico. Em 1958, Cantrell et al2 definiram o espectro completo da síndrome com as seguintes anomalias: defeitos do diafragma anterior, da parte inferior do esterno, da região supraumbilical e parede abdominal, do pericárdio diafragmático, e várias anormalidades congênitas intracardíacas. O presente relato relaciona-se a um caso de ectopia cordis associado à PC e à importância da participação de uma equipe multidisciplinar no acompanhamento da doença.

Open abdomen management is commonly used for the critically injured patients to avoid abdominal compartment syndrome. But it usually continues for days to weeks and finally results in abdominal wall defect that is too wide to close at once. This article presents an alternative approach to close the giant abdominal wall defect by using the combination of bipedicled flaps with the components separation technique and V.A.C.® system.

Background Omphalocele is a congenital midline ventral body wall defect that can exist as isolated malformation or as part of a syndrome. It can be considered one of the major and most frequent clinical manifestation of Beckwith-Wiedemann Syndrome (BWS) in case of loss of methylation at KCNQ1OT1: Transcription Star Site-Differentially Methylated Region (TSS-DMR) or in presence of CDKN1C mutations. The isolated form of the omphalocele accounts approximately for about the 14% of the total cases and its molecular etiology has never been fully elucidated. Methods Given the tight relationship with BWS, we hypothesized that the isolated form of the omphalocele could belong to the heterogeneous spectrum of the BWS associated features, representing an endophenotype with a clear genetic connection. We therefore investigated genetic and epigenetic changes affecting BWS imprinted locus at 11p15.5 imprinted region, focusing in particular on the KCNQ1OT1:TSS DMR. Results We studied 21 cases of isolated omphalocele detected during pregnancy or at birth and identified the following rare maternally inherited variants: i) the non-coding variant G > A at nucleotide 687 (NR_002728.3) at KCNQ1OT1:TSS-DMR, which alters the methylation pattern of the imprinted allele, in one patient; ii) the deletion c.624-629delGGCCCC at exon 1 of CDKN1C, with unknown clinical significance, in two unrelated cases. Conclusions Taken together, these findings suggest that KCNQ1OT1:TSS-DMR could be a susceptibility locus for the isolated omphalocele. Electronic supplementary material The online version of this article (10.1186/s12881-017-0470-z) contains supplementary material, which is available to authorized users.

Summary Objectives Necrotising fasciitis (NF) is a potentially fatal, uncommon infection of the soft tissue with rapid progression. This article presents one case of NF of the abdomen wall, describing the presentation, diagnosis and long-term successful treatment. Methods The defect of the abdominal wall was treated with medical support (antibiotics broad-spectrum coverage), V.A.C. therapy and plastic surgery procedures. Results The coverage of the abdominal wall defect has been achieved by abdominoplasty-type advancement flaps in one step with the preservation of the umbilicus. One month after the surgical procedure, the patient returned to a normal lifestyle with a good quality of life. Conclusion The success of this case should be attributed to an early diagnosis, aggressive debridement and a good intensive medical management; these elements are essential to a better prognosis for NF.

Hypertension affects 1–5% of children and adolescents, and the incidence has been increasing in association with obesity. However, secondary causes of hypertension such as renal parenchymal diseases, congenital abnormalities and renovascular disorders still remain the leading cause of pediatric hypertension, particularly in children under 12 years old. Other less common causes of hypertension in children and adolescents, including immobilization, burns, illicit and prescription drugs, dietary supplements, genetic disorders, and tumors will be addressed in this review.

Sixteen clinically healthy New Zealand white rabbits of either sex were divided into 2 equal groups (I and II) of 8 animals each. Under thiopental sodium (2.5 %) anaesthesia a 2 × 3 cm full-thickness abdominal wall defect in the mid-ventral abdominal wall was created and repaired with an acellular dermal graft (ADG) in all the animals of group I (test group). In animals of group II (control group) a full-thickness linear midline abdominal muscular wall incision was made and repaired with a continuous suture pattern using 2-0 nylon.

We present the extremely rare case of a male newborn with Beckwith-Wiedemann Syndrome (BWS) presenting as delayed abdominal wall closure and neonatal intussusception. Fetal ultrasound had shown omphalocele that resolved spontaneously. When feeding was attempted, he had various episodes of vomiting. An x-ray showed signs of high bowel obstruction. Jejunal intussusception was found on laparotomy. Enterectomy and primary jejuno-jejunal anastomosis was performed. During post-operative period subtle physical findings became prominent: plain hemangioma, posterior helical indentations, and macroglossia. Cardiac ultrasonography showed a patent foramen oval with small left-to-right shunt. Ultrasonography showed renal hyperplasia. Genetic study showed hypomethylation of DMR2 region of 11p15 chromosome.

Background: Abdominal wall defect presents a great challenge when it is large, ruptured, or associated with other anomalies. Objective: To review the challenges and outcome of management of anterior abdominal wall defects (AAWD). Materials and Methods: A retrospective review of omphalocele and gastroschisis managed over 8 years at our institution. Results: Omphalocele (n=49) and gastroschisis (n=7) constituted 2.4% of total admission. The median age was 23.5 hours, with male-female ratio of 1:1.1. Term infants were 91.7% and more than 75% weighed above 2.5 kg. The mean maternal age was 28.5±5.87 years and mean parity was 3.1±2.0, with P values of 0.318 and 0.768, respectively. More than 92.9% of infants were out-born, 46 pregnancies (82.1%) were booked, and 51 (91.1%) had at least one ultrasound scan, but only 1 (1.8%) was diagnosed with gastroschisis. Ruptured omphalocele were 11 (6 major, 5 minor) in number, 3 of which presented with enterocutaneous fi stula, and 3 (6.1%) were syndromic omphalocele. Positive blood culture confi rmed septicaemia in 21 cases (37.5%). Surgical repair was done in 35 cases (62.5%), 44.6% as emergency, and 17.9% as elective. Non-operative management was done in 21 patients (37.5%) and 5 (8.9%) were discharged against medical advice. Median length of hospital stay was 10 days (mean, 15.98±14.38). Postoperative complication rate was 32.1% and overall mortality was 30.4%, with the highest case fatality among gastroschisis (57.1%) and omphalocele major (32.1%). Conclusions: There were large numbers of out-born infants due to poor prenatal diagnosis in spite of high instances of antenatal ultrasound scan. Many patients presented with complications that resulted in poor outcome.Key words: Abdominal wall defects, challenges, gastroschisis, omphaloceles, outcomes

WOS: 000237015800053 PubMed: 16567201 Purpose: To show the effect of botulinum A toxin-induced paralysis of abdominal muscles oil intraabdominal pressure. Material and Methods: Fifteen Sprague-Dawley rats were divided into 2 groups. An abdominal skin incision was done, and 2 catheters were placed for the pressure monitoring and saline infusion. Saline Solution was given to the abdomen until reaching to a pressure level of 9 cm H2O and 6 min Hg in pressure device, and the amounts of injected saline were recorded. Then intraabdominal saline was drained. Two milliliters (5 U/mL) botulinum A toxin was applied to the abdominal muscles in group 2. Saline was injected at the same points in same amounts in group 1. After 3 days, catheters were placed, and the saline volumes needed to obtain the same pressure levels were recorded for each rat. Spontaneous motor unit potential (MUP), single MUP analysis and interference patterns of the muscles, respiratory rates, and vascular pressure measurements were recorded before and after botulinum toxin (Botox) injections. Results: Mean intraabdominal saline volumes in the first and third days were 63.8 and 64.4 mL in group 1 and 67.6 and 80.6 mL in group 2, respectively. Mean MUP amplitude and duration of the rectus muscles in group 2 (17.1 mu V and 1.47 milliseconds) were significantly lower than those of group I (187 mu V and 4.9 milliseconds) in the third day. There were no pathological changes in respiratory rates and pressure measurements before and after Botox injections. Conclusion: This pilot experimental study showed that local injection of botulinum A toxin causes paralysis in abdominal wall muscles, increases the intraabdominal volume, and decreases the pressure, and this application may be used as ail adjunct in abdominal Wall Closure in selective cases. (c) 2006 Elsevier Inc. All rights reserved.

Myoblasts were obtained by culturing in vitro, single muscle fibers, isolated by enzymatic digestion from rat flexor digitorum brevis, and their phenotype was confirmed by myogenic differentiation factor, myogenic factor-5, myogenin and desmin. Cultured myoblasts were harvested and seeded on patches of homologous acellular matrix, obtained by detergent-enzymatic treatment of abdominal muscle fragments. Myoblast-seeded patches were inserted between obliqui abdominis muscles on the right side of 1-month-old rats, while non-seeded patches were implanted on the left side. Thirty days after surgery, non-seeded patches were completely replaced by fibrous tissue, while the structure of myoblast-seeded patches was well preserved until the 2nd month. Seeded patches displayed abundant blood vessels and myoblasts, and electromyography evidenced in them single motor-unit potentials, sometimes grouped into arithmic discharges. Ninty days after implantation, the thickness of myoblast-seeded patches and their electric activity decreased, suggesting a loss of contractile muscle fibers. In conclusion, the present results indicate that autologous myoblast-homologous acellular muscle matrix constructs are a promising tool for body-wall defect repair, and studies are under way to identify strategies able to improve and maintain the structural and functional integrity of implants for longer periods.

The reconstruction of large abdominal wall defects still is a major surgical problem. Many different techniques have been developed for this purpose, most of which appeared to be unsatisfactory. The lack of sufficient tissue requires the insertion of prosthetic material. Non-absorbable prostheses used to reconstruct abdominal wall defects showed the best results . Polypropylene mesh (PPM) and expanded polytetrafluoroethylene (ePTFE) soft-tissue patch are the most frequently used materials for this purpose . However, PPM induces extensive visceral adhesions and erosion of the skin, whereas ePTFE is insufficiently anchored to the adjacent tissue and therefore both materials are not ideal. As a result of own clinical and experimental studies , we constructed a new prosthesis that combines the favourable properties and avoids the drawbacks of PPM and ePTFE and tested it in an experimental study in the rat. The results are promising and warrant future study to find the ideal non -absorbable prosthesis to reconstruct large abdominal wall defects.

The rupture of an omphalocele sac during birth is a well recognized entity. The associated lesions due to vascular compromise can result in necrosis of the bowel with perforation. Spontaneous bowel perforation in an omphalocele at birth is not reported in the literature. We describe a case with bowel perforation at the fundus of an omphalocele in a newborn.

The purpose of the present study was to analyze the use of autologous dermis compared to non-biological meshes in repair of abdominal wall defects in patients with redundant skin and immunosuppression.Eighteen patients with abdominal wall defects, immunosuppression and with redundant skin were divided into two groups: Group A consisted of 11 patients treated with autologous dermis. In these patients, autologous dermis was isolated from the amount of skin resected from the inferior abdominal region that was used as a reinforcement of fascial margins above the defect. Group B consisted of seven patients treated with non-biological meshes We evaluated the infection rate of these groups.The infection rate was significantly lower in group A patients.The transplantation of autologous dermis as a reinforcement for the reconstruction of abdominal wall defects is reasonable for highly selected patients. The use of the dermis was proven useful and we found a lower rate of infection and recurrence.