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The split abdominal wall muscle flap repair for large congenital diaphragmatic hernias on extracorporeal membrane oxygenation
- Source :
- Journal of Pediatric Surgery. 42:1047-1051
- Publication Year :
- 2007
- Publisher :
- Elsevier BV, 2007.
-
Abstract
- Background: Numerous techniques exist for repairing large congenital diaphragmatic hernias (CDHs) including prosthetic patches, tissue-engineered grafts, and various muscle flaps. A split abdominal wall muscle flap is a simple, durable way to repair a large diaphragmatic hernia. This technique has not gained widespread use, and some have suggested that it would be inappropriate in the setting of extracorporeal membrane oxygenation (ECMO) because of bleeding risk. We present our series of diaphragmatic hernias with a focus on those repaired with the split abdominal wall technique while on ECMO. Methods: A retrospective, single-institution chart review was performed on all patients who underwent surgical repair for CDH over 6 years beginning in August 2000. Results: Seventy-five patients underwent repair. Sixteen were performed with patients on ECMO. Of these, 4 were closed primarily, 7 used a prosthetic patch, and 5 used a split abdominal wall muscle flap. Two patients in the prosthetic group developed a recurrent hernia, and 2 required reoperation for bleeding while on ECMO. No reoperations for bleeding were required in the abdominal muscle flap group. Conclusions: The split abdominal wall muscle flap can be safely performed on anticoagulated patients. We believe it is a practical option for repairing large CDHs.
- Subjects :
- Male
Reoperation
medicine.medical_specialty
medicine.medical_treatment
Diaphragmatic breathing
Platelet Transfusion
Postoperative Hemorrhage
Surgical Flaps
Abdominal wall
Plasma
Extracorporeal Membrane Oxygenation
Postoperative Complications
Recurrence
Extracorporeal membrane oxygenation
medicine
Humans
Diaphragmatic hernia
Hernia
Retrospective Studies
Aminocaproates
Hernia, Diaphragmatic
Surgical repair
Factor VIII
business.industry
Abdominal Wall
Infant, Newborn
Anticoagulants
Fibrinogen
Congenital diaphragmatic hernia
General Medicine
Surgical Mesh
medicine.disease
Surgery
surgical procedures, operative
medicine.anatomical_structure
Surgical mesh
Hematocrit
Pediatrics, Perinatology and Child Health
Female
Erythrocyte Transfusion
Hernias, Diaphragmatic, Congenital
business
Subjects
Details
- ISSN :
- 00223468
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Surgery
- Accession number :
- edsair.doi.dedup.....b4685abfa42c84e9a192335f54ee9120