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                

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

Conflicts of Interest

The authors declare no conflicts of interest.

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