orabase and Hernia--Umbilical

The surgical management of a giant omphalocele is challenging. Many cannot be closed at birth and must initially be managed nonoperatively with a topical agent to facilitate epithelialization. We report the case of a term, 1-day-old female neonate with a giant omphalocele treated initially with a hydrofiber dressing containing silver (Aquacel Ag; ConvaTec Inc, Skillman, NJ) and then with delayed primary closure.

Topics: Anti-Infective Agents, Local; Carboxymethylcellulose Sodium; Female; Hernia, Umbilical; Humans; Infant, Newborn; Occlusive Dressings; Silver Sulfadiazine

Historically, some dressings used in exomphalos major were associated with toxicity. These have been abandoned in favor of safer dressings. Silver toxicity has not been described following the use of silver dressings in infants. We, however, found disconcerting serum silver levels in 2 consecutive patients during treatment with silver salt containing dressings.

Topics: Anti-Infective Agents, Local; Bandages; Carboxymethylcellulose Sodium; Cesarean Section; Combined Modality Therapy; Compression Bandages; Elective Surgical Procedures; Female; Fundoplication; Hernia, Umbilical; Humans; Infant, Newborn; Occlusive Dressings; Petrolatum; Prenatal Diagnosis; Rupture, Spontaneous; Silver; Silver Sulfadiazine; Suture Techniques