Abstract
The patient was a newborn girl with a giant omphalocele with the liver and intestine contained within a sac. Primary closure was difficult. A silo was prepared by affixing Aquacel®Ag to the hernia sac and fixing Alexis® Wound Retractor to the skin by suture. The silo was removed 7 days after birth. The hernia sac was covered with Aquacel®Ag and TegadermTM, and they were replaced every week. The hernia sac gradually epithelialized, and epithelialization became complete 3 months after birth. Surgery for abdominal wall closure was performed 7 months after birth. The hernia orifice was measured to be about 7 × 7 cm, the liver and intestine were prolapsed, and no adhesion in the abdominal cavity was noted. The fascia could be closed by suture without tension by the component separation technique, and the respiratory and hemodynamic conditions were stable during and after surgery. Delayed abdominal wall closure could be carried out by this method through the epithelialization of the hernia sac with no effect on the general condition. This method may be a useful option for the treatment of a giant omphalocele.
