Open AccessDOME-SHAPED PATCH OFFERS OPTIMAL BIOMECHANICS FOR REPAIR OF LARGE DEFECTS IN CONGENITAL DIAPHRAGMATIC HERNIA
Author(s) -
Amulya K. Saxena
Publication year - 2014
Publication title -
acta medica medianae
Language(s) - English
Resource type - Journals
eISSN - 1821-2794
pISSN - 0365-4478
DOI - 10.5633/amm.2014.0408
Subject(s) - medicine , congenital diaphragmatic hernia , surgery , diaphragm (acoustics) , ileus , thorax (insect anatomy) , prosthesis , diaphragmatic breathing , hernia , diaphragmatic hernia , rib cage , anatomy , fetus , pregnancy , genetics , alternative medicine , pathology , biology , physics , acoustics , loudspeaker
The surgical management of congenital diaphragmatic hernia (CDH) using biomaterials is still not clearly understood. A neonate with a large left-sided CDH and severe pulmonary hypoplasia was offered surgical closure of the defect using a polytetrafluoroethylene (PTFE) patch on the 12th day after birth. The infant presented with a recurrence 2.5 months later as an emergency with intestinal herniation in the thorax manifesting in the form of a mechanical ileus. The recurrence was managed using a cone-shaped PTFE patch with tension-free approximation to the residual diaphragm and ribs. Six months after the second repair, the infant presented a second recurrence detected during a regular follow-up examination. The second recurrence was managed with a dome-shaped PTFE and polypropylene (PP) patch (composite prosthetic) which offered the advantage of providing a larger volume for the accommodation of the intestinal viscera. The follow-up examinations over the past 12 months have been uneventful