Increased survival with new techniques in treatment of gastroschisis.

Since the opening of the Neonatology Unit, we have become the referral center for our area for problems in the newborn. In the past three years, we have treated five full-term and two premature infants with gastroschisis. There was one death in a premature infant. With an aggressive therapeutic approach and a new surgical technique, we have achieved an overall survival rate of greater than 85%. Primary closure was possible in three patients, with the remaining four being trreated in two stages. A modification of the Schuster silastic bag closure was first accomplished in those patients treated in two stages. Definitive surgical correction was completed within eight days of birgh in all seven patients. No ventral hernias or wound infections occurred using the new technique. Careful preoperative transport and management, judicious anesthesia, antibiotics, ventilatory support, and parenteral hyperalimentation when necessary, have all contributed to our increased survival rate and decreased morbidity.