TITLE:
Vacuum Assisted Closure (VAC) and Platelet-Rich Plasma (PRP): A Successful Combination in a Challenging Case of Gastroschisis
AUTHORS:
Vincenzo Domenichelli, Simona Straziuso, Maria Domenica Sabatino, Silvana Federici
KEYWORDS:
Vacuum Assisted Closure, Gastroschisis, Platelet-Rich Plasma, Abdominal Wall Defect
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.5 No.3,
September
23,
2015
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.