XXXX : a simple technique for staged silo closure.

@entity1 @entity4438 @entity4 @entity6675 @entity3575
In conjunction with the Neonatology Department at Loma Linda University @entity1 's Hospital, a new protocol has evolved for the management of @entity1 with @entity6675 , which obviates both risks associated with primary and staged silo closure. After stabilization of the @entity1 in the neonatal intensive care unit, under sterile conditions, a 5- or 7-cm SILASTIC silo with a spring-loaded ring is placed over the exposed viscera, under the @entity4438 . No sutures are required. A @entity3575 drip is given, and the bowel is gradually reduced over the next few days. The transparent material of the silo allows for continuous monitoring of the condition of the bowel. Second-stage closure in the operating room is performed using a purse-string suture in the fascia to create a pseudoumbilicus. From October 1992 to April 1994 the authors managed 10 @entity1 using this protocol. The results are compared with those of @entity1 with @entity6675 treated at the same institution between August 1982 and June 1993. Outcome parameters to be compared include time until closure, time on ventilation, days of total parenteral nutrition, time until start of oral feeding, time until toleration of full-volume oral feeding, and time until discharge. The authors conclude that silo closure in the neonatal intensive care unit is simple, quick, and effective. It eliminates multiple trips to the operating room, allows the natural accommodation of the bowel into the abdominal cavity with @entity4 and minimal vascular compromise, and has become the authors' treatment of choice for @entity1 with @entity6675 .
