Vacuum Assisted Closure (VAC) and Platelet-Rich Plasma (PRP): A Successful Combination in a Challenging Case of Gastroschisis

Vincenzo Domenichelli; Simona Straziuso; Maria Domenica Sabatino; Silvana Federici

doi:10.4236/ojped.2015.53041

Home > Journals > Medicine & Healthcare > OJPed

Open Journal of Pediatrics > Vol.5 No.3, September 2015

Vacuum Assisted Closure (VAC) and Platelet-Rich Plasma (PRP): A Successful Combination in a Challenging Case of Gastroschisis ()

Vincenzo Domenichelli^*, Simona Straziuso, Maria Domenica Sabatino, Silvana Federici

Pediatric Surgical Unit, “Infermi” Hospital, AUSL Romagna, Rimini, Italy.

DOI: 10.4236/ojped.2015.53041 PDF HTML XML 4,403 Downloads 5,129 Views

Abstract

Giant gastroschisis could be a surgical challenge concerning the abdominal wall reconstruction. Many techniques have been described for both primary or staged closure but sometimes neither of them is succesful in all patients. We are presenting the combined use of Vacuum Assisted Closure (VAC) and Platelet-Rich Plasma (PRP) to improve the result in this difficult case. The use of VAC device is a well known procedure in the treatment of adult difficult wounds closure. It consists of a sponge applied directly on the abdominal wall defect, covered with a transparent dressing and connected to a controlled continuous negative pressure system [1]. Platelet-rich plasma (PRP) is an autologous concentration of human platelets in a small volume of plasma. Due to this combination it provides multiple growth and healing factors actively secreted by platelets which have been shown to begin and accelerate wound healing [2] [3]. The association between VAC and PRP was effective in the shrinkage and reduction of the abdominal defect. Fifteen months after the removal of the VAC device the fascia appears competent with a cutaneus scar that will need a plastic correction in the future. The VAC should be considered as a helpful and effective device in case of complicated giant gastroschisis or omphalocele when traditional treatment is not sufficient.

Keywords

Vacuum Assisted Closure, Gastroschisis, Platelet-Rich Plasma, Abdominal Wall Defect

Share and Cite:

Domenichelli, V. , Straziuso, S. , Sabatino, M. and Federici, S. (2015) Vacuum Assisted Closure (VAC) and Platelet-Rich Plasma (PRP): A Successful Combination in a Challenging Case of Gastroschisis. Open Journal of Pediatrics, 5, 274-278. doi: 10.4236/ojped.2015.53041.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Kilbride, K.E., Cooney, D.R. and Custer, M.D. (2006) Vacuum-Assisted Closure: A New Method for Treating Patients with Giant Omphalocele. Journal of Pediatric Surgery, 41, 212-215. http://dx.doi.org/10.1016/j.jpedsurg.2005.10.003
[2]	Marx, R.E. (2004) Platelet-Rich Plasma: Evidence to Support Its Use. Journal of Oral and Maxillofacial Surgery, 62, 489-496. http://dx.doi.org/10.1016/j.joms.2003.12.003
[3]	Sidman, J.D., Lander, T.A., et al. (2008) Platelet-Rich Plasma for Pediatric Tonsillectomy Patients. Laryngoscope, 118, 1765-1767. http://dx.doi.org/10.1097/MLG.0b013e31817f18e7
[4]	Bianchi, A. and Dickson, A.P. (1998) Elective Delayed Reduction and No Anesthesia: “Minimal Intervention Management” for Gastrochisis. Journal of Pediatric Surgery, 33, 1338-1340. http://dx.doi.org/10.1016/S0022-3468(98)90002-1
[5]	Baird, R., Gholoum, S., Laberge, J.M., et al. (2010) Management of a Giant Omphalocele with an External Skin Closure System. Journal of Pediatric Surgery, 45, 17-20. http://dx.doi.org/10.1016/j.jpedsurg.2010.05.004
[6]	Gabriel, A. and Gollin, G. (2006) Management of Complicated Gastroschisis with Porcine Small Intestinal Submucosa and Negative Pressure Wound Therapy. Journal of Pediatric Surgery, 41, 1836-1840. http://dx.doi.org/10.1016/j.jpedsurg.2006.06.050
[7]	Fenton, S.J., Dodgion, C.M., Meyer, R.L., et al. (2007) Temporary Abdominal Vacuum-Packing Closure in the Neonatal Intensive Care Unit. Journal of Pediatric Surgery, 42, 957-961. http://dx.doi.org/10.1016/j.jpedsurg.2007.01.029
[8]	McCord, S.S., Naik-Mathuria, B.J., Murphy, K.M., et al. (2007) Negative Pressure Therapy Is Effective to Manage a Variety of Wounds in Infants and Children. Wound Repair and Regeneration, 15, 296-301. http://dx.doi.org/10.1111/j.1524-475X.2007.00229.x
[9]	Miller, P.R., Meredith, J.W., Johnson, J.C., et al. (2004) Prospective Evaluation of Vacuum-Assisted Fascial Closure after Open Abdomen. Annals of Surgery, 239, 608-616. http://dx.doi.org/10.1097/01.sla.0000124291.09032.bf
[10]	Fleck, T., Simon, P., Burda, G., et al. (2006) Vacuum Assisted Closure Therapy for the Treatment of Sternal Wound Infections in Neonates and Small Infants. Interactive CardioVasc Thoracic Surgery, 5, 285-288. http://dx.doi.org/10.1510/icvts.2005.122424
[11]	Butter, A., Emran, M., Al-Jazaeri, A., et al. (2006) Vacuum-Assisted Closure for Wound Management in the Pediatric Population. Journal of Pediatric Surgery, 41, 940-942. http://dx.doi.org/10.1016/j.jpedsurg.2006.01.061
[12]	Mazzucco, L., Borzini, P. and Gope, R. (2010) Platelet-Derived Factors Involved in Tissue Repair from Signal to Function. Transfusion Medicine Reviews, 24, 218-234. http://dx.doi.org/10.1016/j.tmrv.2010.03.004
[13]	Nagaveni, N.B., Praveen, R.B., Umashankar, K.V., et al. (2010) Efficacy of Platelet-Rich Plasma (PRP) in Bone Regeneration after Cyst Enucleation in Pediatric Patients—A Clinical Study. Journal of Clinical Pediatric Dentistry, 35, 81-87. http://dx.doi.org/10.17796/jcpd.35.1.q69168v5268234k9