Ventral Hernia in the Treatment of Omphalocele and Gastroschisis

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Abstract
Patients (23) with gastroschisis or omphalocele undergoing delayed ventral herniorrhaphy were reviewed. The ventral defects resulted from elective skin flap coverage in 15 patients, prosthetic silo failure in 5 and nonoperative management using escharotic agents in 3. Herniorrhaphy was performed at 2 mo. to 15 yr of age. Fascial closure was achieved in a single procedure in 15 patients (65%) and with multiple operations involving prosthetic material in 5 patients (22%). Three patients (13%) had prosthetic material left in their defects without sequelae. There was no operative mortality from interval herniorrhaphy, and complications were minor. Conversion of a gastroschisis or an omphalocele to a ventral hernia is strategically useful in an infant with a giant defect, prosthetic silo failure, or when associated anomalies preclude early definitive surgery.