EXTERNAL COMPRESSION AS INITIAL MANAGEMENT OF GIANT OMPHALOCELES

The authors describe a noninvasive technique for the management of gia nt omphaloceles. Two patients with giant omphaloceles were managed wit h external compression. Dry sterile dressings were used, buttressed by an Ace bandage in the first case and by a handcrafted Velcro abdomina l binder in the second. The binder was tightened every 2 or 3 days. Re nal, cardiovascular, respiratory, and gastrointestinal parameters were measured regularly to determine whether the binder was too tight. The first patient had only occasional emesis. and the defect was repaired after 40 days of compression. The second patient experienced intermit tent hypertension, occasional emesis, and mild oxygen desaturation, wh ich resolved when the binder was loosened slightly. The fascia muscle and skin were closed after 30 days of external compression. Both patie nts are currently living at home and doing well. This form of external compression is an effective. inexpensive, and low-risk method for the gradual reduction of giant omphaloceles, and should be considered for patients born with this problem. Copyright (C) 1996 by W.B. Saunders Company