SUCCESSFUL MANAGEMENT OF STAGE 4S NEUROBLASTOMA AND SEVERE HEPATOMEGALY USING ABSORBABLE MESH IN AN INFANT

This report describes the use of an absorbable mesh in an infant with stage 4S neuroblastoma who required decompressive laparotomy. At the t ime of laparotomy, a SILASTIC(R) site was placed. After 12 days, the l iver had not reduced in size despite chemotherapy and radiation therap y. Because of concern for infection, the silo was removed, and an abso rbable polygalactin (Vicryl) mesh was placed. Wet-to-dry dressings wer e used to manage the mesh. A granulation base developed that provided a physiological closure of the abdominal cavity. Forty-two days after placement of the absorbable mesh, the liver had reduced to a size that permitted mobilization of skin flaps for a surgical abdominal closure . The liver continued to reduce in size, allowing the fascial edges to draw together. The patient is now 2 years old with no signs of residu al tumor or ventral hernia. Copyright (C) 1998 by W.B. Saunders Compan y.