Abdominal Wall Defect

Congenital abdominal wall defect 3 Gastroschisis ( 45) Omphalocele ( 44)

prune belly syndrome

Gastroschisis 45

Gastroschisis 2 gaster schisis gaster

schisis gastroschisis
( omphalocele 44
omphalocele) (viscera
eviscerate)
eviscerate

eviscerate
fibrin

umbilical vein ( right umbilical vein)

umbilical vein umbilical vein

umbilical vein
fetus
umbilical vein

umbilical vein

viscera eviscerate

gastroschisis
viscera eviscerate viscera



gastroschisis 10% malrotation, intestinal
atresia



contaminate sterile technique
gauze normal saline contaminate gauze normal
saline eviscerate gauze

ischemia gauze
NG tube aspirate content decompress bowel
IV fluid 10% D-NSS/5 loss maintainance
gastroschisis fluid loss 5%
systemic antibiotics gram negative bacilli
keep warm radiant warmer incubator

1.
(primary closure) 30
2.

(staged closure) 12

decompress bowel reduce bowel

fascia

ventral hernia
reduce viscera fascia
skin reduce
reduce

viscera eviscerate


fascia

Primary closure of abdominal wall

stable 45
08 09 normal saline
30 decompress bowel
retrograde decompress small bowel content
antegrade decompress large bowel meconium
dissect 2 fascia

29
fascia plication interupted horizontal matress 28 27


26

Staged closure of abdominal wall

(artificial sac)
stockinett steridrape

sterile 01
steridrape 02
03
stockinett 04
steridrape 05 stockinett
steridrape stockinett
stockinett steridrape 06
stockinett 07
04
stockinett steridrape 05
stockinett stockinett
steridrape
07

gastroschisis 45

eviscerate
normal saline 09


10
11
povidone iodine 12
gauze povidone iodine sterile
contamination 13
gauze 14

 ward incubator 14
dressing sterile technique
15
stockinett steridrape
steridrape inert organism steridrape
steridrape peritoneum membrane

dressing sterile technique

16

17 18
5 7 19

fibrin pseudomembrane
coat 20
dissect 2 fascia abdominal wall muscle

fascia horizontal interrupted matress 21

22
7 ventral hernia fascia
23

gastroschisis ileus
ileus function 2 3

NPO parenteral nutrition

2 3
4
followup 3 24

Omphalocele 44
Omphalocele 2 omphalos cele omphalos cele
omphalocele
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