Witt RG, et al. - In this cohort review of 97 neonates, researchers compared the clinical outcomes of sutureless vs sutured gastroschisis repair. Outcomes revealed a statistically significant decrease in mechanical ventilation duration and pain medication necessities in correlation to sutureless repair of gastroschisis, however, it may increase umbilical hernia risk.

Methods

• For this study, all consecutive patients who underwent gastroschisis repair from February 1, 2007 to April 30, 2017, at the University of California, San Francisco were reviewed.
• Clinical characteristics and outcomes were determined via analyzing patients’ medical records; they excluded cases with incomplete data during initial hospitalization.
• Main outcomes assessed included 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

• Gastroschisis repair was performed on 97 patients (47 [48%] were female and 50 [52%] were male with a mean [SD] age of 2.8 [2.8] days); 7 patients were excluded due to incomplete medical records.
• Among the 90 patients included in the study, sutured closure was performed on 50 (56%) and sutureless closure on 40 (44%).
• The sutured and sutureless groups were not statistically different in terms of 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 sutureless group vs the sutured 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 < .001).
• Considerably more umbilical hernias requiring surgical repair were encountered in the sutureless closure group compared with the sutured group (5 [13%] vs 0; P=.02).