Witt RG, et al. - Researchers compared sutureless vs sutured gastroschisis repair in terms of clinical outcomes in this single-center cohort review. Findings from the present study suggested that sutureless repair of gastroschisis seems to be correlated with a statistically significant decrease in duration of mechanical ventilation and need for pain medication but could increase umbilical hernia risk. They did not find substantial differences between the sutured and sutureless groups in wound infection rates, time to full enteral feeds, total parenteral nutrition duration, length of hospital stay, and serious complication rates.

Methods

• Study participants were all consecutive patients (n = 97) who had gastroschisis repair from February 1, 2007 to April 30, 2017 at the University of California, San Francisco.
• For clinical characteristics and outcomes, patients’ medical records were evaluated.
• Researchers excluded cases with incomplete data during initial hospitalization.
• Main outcomes and measures analyzed were length of hospital stay, time to full enteral feeds, total parenteral nutrition duration, days requiring intravenous analgesia, days intubated, wound infection rate, antibiotic treatment duration, rate of umbilical hernias that required an operation, and readmission rate.

Results

• According to the findings, 97 subjects (47 [48%] were female and 50 [52%] were male with a mean [SD] age of 2.8 [2.8] days) had gastroschisis repair, of which 7 were excluded for incomplete medical record.
• Out of 90 subjects involved in the investigation, 50 (56%) had sutured closure and 40 (44%) had sutureless closure.
• They did not find statistical difference between the sutured and sutureless groups in length of hospital stay (mean [SD] days, 43.9 [40.4] vs 36.7 [21.2]; P=.71), time to full enteral feeds (mean [SD] days, 31.4 [20.2] vs 27.9 [17.3]; P=.22), total parenteral nutrition duration (mean [SD] days, 33.5 [29.8] vs 27.4 [18.2]; P=.23), wound infection rates (14 [28%] vs 10 [25%]; P=.81), and readmission rates (5 [10%] vs 7 [18%]; P=.36).
• The study results showed that compared with the sutured group, the sutureless group had substantially fewer days receiving antibiotics (mean [SD], 7.2 [6.4] vs 12.4 [13.2]; P=.003), fewer days intubated (mean [SD], 2.8 [3.3] vs 6.8 [1.3]; P=.001), fewer days receiving intravenous analgesia (mean [SD], 4.2 [4.0] vs 7.1 [4.5]; P=.003), and fewer patients that required silo reduction (25 [63%] vs 48 [96%]; P
• Compared with the sutured technique, sutureless closures had considerably more umbilical hernias requiring surgical repair (5 [13%] vs 0; P=.02).