This study describes the first-ever gastroschisis patient managed. Chapter 4 Inside out. Silo Bags are indicated for the protection of the exposed bowel in infants and are. While spring-loaded silo bags have the best outcomes, improvised silos and sutured urine bags provide alternative solutions for delayed closure in LICs. 10, 21 Gastroschisis defects commonly have a diameter of 1. Segura, Hilary Alpert, Daniel H. Design Retrospective review comparing neonates with. tured silo, resulting in a long-term cosmetic benefit. Disposable Surgical Instrument Wound Protector Surgical Retractor for Gastroschisis. PUBLISHED. 3 kg, the patient is significantly small making reduction of the abdominal contents untenable. (12)(13)(14) (15) (16)(17) The Silo is a synthetic bag designed to cover the gastroschisis and is fixed to the abdominal wall, normally the fascia. A meta-analysis conducted by Kunz et al. outcomes. Overall, the incidence seems to have increased over the last decades. Bentec Medical GR74089-06 - BAG, SILO VENTRAL WALL DEFECT, 3CM, EACH. This means the baby weighs less than we would expect for the gestational age. SSP Silo Bags provide a secure, closed environment for exposed viscera during the staged closure of congenital ventral wall defects. For the staged reduction of gastroschisis and omphalocele Choose from bag openings with a wire spring encapsulated in silicone or a wire-free ring. 4 No. There were 12 patients who fell into the urobag group, 6 patients diagnosed as having gastroschisis and ruptured omphalocele each. Specialty: Pediatric Surgery. 1 It can be diagnosed by prenatal ultrasound or upon birth through physical examination. Mustafa Kabeer is a board-certified pediatric surgeon at CHOC, performing all types of general surgery and specializing in pectus excavatum (sunken chest), lung resection, hernia and robotic surgery. 6%, and 83. 9%, 14/23, 1996–2003, p = 0. This happens because a hole was left in the abdominal wall when it formed during pregnancy. 1. 1. 54847/cp. The authors report their experience with the use of a polyvinyl chloride (PVC) bag for blood-derivative transfer as a prosthesis for the creation of a silo for surgical treatment of gastroschisis (GS) in seven newborn infants. In the past, a silo was created using sterile plastic bags and typically sutured to the abdominal wall. Since 1995 a spring-loaded silo has been made commercially available that is commonly used [39,40,41] (Figure 1b). loaded silo for gastroschisis: impact on practice patterns and. 002 Corpus ID: 201714237; Immediate Versus Silo Closure for Gastroschisis: Results of a Large Multicenter Study. 1016/j. Disposable Silo Bag for Gastroschisis, Find Details and Price about Surgical Instrument Medical Device from Disposable Silo Bag for Gastroschisis - Microcure (Suzhou). [Google Scholar] 42. 1%. Keywords: Gastroschisis; Skin flap coverage; Ventral Hernia; Silo; Abdominal wall defects Introduction Gastroschisis is a challenging problem in developing communities due to high incidence and poor facilities. A cheaper and easily available urobag has been tried for staged reduction with more than satisfactory outcome in cases of gastroschisis in preterm and low birth weight infants. The herniated contents, which included the large bowel, small bowel and stomach, were placed inside a 4 cm silo and the ring was inserted within the umbilical defect. Delivery room management of the infant with gastroschisis has included the use of sterile bowel bags and/or saline-soaked gauze dressings to prevent damage to the exposed intestines. Hot Products China Products China Manufacturers/Suppliers. Hawkins RB, Raymond SL, St Peter SD, Downard CD, Qureshi FG, Renaud E, Danielson PD, Islam S. Gastroschisis in a premature infant in Papua New Guinea: initial treatment with a normal saline bag silo. Gastroschisis is the most common abdominal wall defect in the newborn, and incidence is increasing worldwide, affecting 4–5/10,000 newborns (1, 2). Production Capacity: 10000PCS/Month. Design Population based cohort study of all liveborn infants with gastroschisis born in the United Kingdom and Ireland from October 2006 to March 2008. ) • Dx by 2D US at 18wk • Dx by 3D US at 1st TM • The incidence of omphalocele seen at 14–18 weeks is as high as 1 in 1,100 • incidence at birth drops to 1 in 4,000–6,000 • Implies the hidden fetal death. 1001/archsurg. S. The main treatment options are primary closure or delayed closure with use of a silo. In patients with simple gastroschisis, the mean LOS is 41 ± 32 days and the mortality rate is 3. There is a hole in the abdominal wall. Fortunately, treatment of a left-sided gastroschisis is identical to that of the right-sided form [2]. Placing a spring-loaded silo bag as a bedside procedure without anesthesia on newborns with severe gastroschisis whose viscera cannot be reduced primarily has increased the survival rate (94. A spring loaded readymade transparent silastic silo is used to cover herniated bowel. We designed a single institution pilot study to assess whether simulation-based training (SBT) for placement of a silastic silo. Silos yielded a diameter of 5. Gastroschisis is a relatively uncommon condition that occurs in approximately 1 in 5,000 live births. we are billing an unlisted procedure for silo placement with a resection of the small intestine. A spring-loaded 5-cm Silicone Silo Bag was placed at birth (Bentec Medical, Woodland, California, United States) and was eventually upsized to a 7. The silo is supported over the baby's belly (see Picture 1). Our transparent, soft, flexible Silicone Silo Bags cover & protect the visceral content while providing direct visualization of the bowel. In more severe cases, your baby will receive a silo, a special silicone sack that is placed over the exposed intestines. doi: 10. 2013;48:845–57. Final result after fascial closure. Results: One hundred fifty infants were included, and 139 (92. Conclusion Management of gastroschisis remains challenging in resource-limited regions. (%) of Patients P Valuea 1998-2003 (n=45) 2004-2007 (n=46) Wound infection 1 (2) 4 (9) . 24294/JPEDD. Rural and Remote Health 2022; 22: 707 4. View All. 15. Application of silo is done under sedation. Teitelbaum, James D. Gastroschisis is a congenital anomaly in which abdominal organs, primarily small and large bowel, protrude through a defect near the umbilicus; thus, babies are born with their intestines exposed. Between 1993 and 1997, 38 children presented with gastro-schisis. We present three such patients in which we formed a stoma through the silo pouch owing to these complications. Silicone Silo Bags For the staged reduction of gastroschisis and omphalocele. Office: 714-364-4050. 1% (13 cases). Gastroschisis is a type of abdominal wall defect. The iron + sewn seal, sewn seal, and ironed seal on the silos yielded tensile strengths of 31. Characteristics and outcomes were compared between groups. In general, affected infants do not have other life-threatening anomalies, and surgical management. The use of an SLS placed at the bedside has resulted in lower immediate fascial closure rates for infants with gastroschisis without significant detrimental clinical outcome. 8. Ships Within Special Order. J Pediatr Surg. During the period 1996-98, 5 neonates underwent operative repair of gastroschisis at the Department of Pediatric Surgery, Christian Medical College Hospital, Vellore. ACCEPTED: 21 November 2021. o Secure silo to overhead warmer with trach string ties to keep silo contents completely perpendicular to infant abdomen. A separate population-based study of 502 Australian infants with abdominal wall defects (166 omphalocele, 336 gastroschisis) reported similar findings of longer hospital stays and parenteral nutrition as well as higher rates of infection but lower overall mortality in infants with gastroschisis compared to those with omphalocele. Approximately 16,000 babies are born with gastroschisis across sub-Saharan Africa each year with a mortality rate of 75-100%. By day of life (DOL) 22, minimal visceral contents had been reduced, and the silo was difficult to maintain due to the large size of the fascial defect and loss of abdominal. Gastroschisis is a defect in the abdominal wall. At 4 weeks of gestation the abdominal wall forms and during the 6 th week the midgut. Lobo, Anne C. 1 ± 2. Source is not about this particular baby’s case but about how gastroschisis is treated. Silo medicina pre-formed I icon e sil os @medicina Silo Silo An innovative surgical solution for infants with Gastroschisis medicina p re-formed s ilicone s mos medicna preomed silicone silos Medicina Silos are pre-formed silicone bags indicated for use in infants with gastroschisis. Gastroschisis is a paraumbilical, full-thickness abdominal wall defect associated with protrusion of the bowel through the defect. 8 ± 6. Babies of mothers under the age of 20 are at an increased risk. 9. Geiger, George B. 1007/s003830050629 [Google Scholar] 17. Babies with gastroschisis often undergo surgery to close the abdominal wall defect the day they are born. Emil S. This is a 17cm long polyurethane bag with a neck diameter of 7. Dr. Often, the intestines don't fit in the belly because they're swollen. Objective To evaluate the impact of the use of a bedside-placed spring-loaded silo (SLS) on practice patterns and on outcomes for infants with gastroschisis. Median silo size was 4 cm, and time of application was 2. Gastroschisis is when a baby is born with the intestines sticking out through a hole in the belly wall near the umbilical cord. 026, Chi. Kabeer, Mustafa H. Placing a spring-loaded silo bag as a bedside procedure without anesthesia on newborns with severe gastroschisis whose viscera cannot be reduced primarily has increased the survival rate (94. Currently, tertiary hospitals in low-income countries experience great difficulty in purchasing these bags. Most cases of fetal gastroschisis involve the intestine and other. The purpose of this study was to compare outcomes between each approach using a multicenter retrospective analysis. 10. This study compared the outcomes of these two techniques. In the absence of standard silos we decided to use latex surgical gloves as a silo bag. Treatment for gastroschisis and its morbidity and mortality rates vary widely both on a local and global level . 2015 Jul 1;4(3):28. S. The bag is sterile, impermeable to micro-organisms, transparent, flexible. J Pediatr Surg. The silo bag was then hung upright. In one-third to one-half of babies with gastroschisis, the belly is not big enough to put all the bowels back right away. Sometimes, gastroschisis can be repaired surgically at birth. Gastroschisis: an update. Silo inaccessibility contributes to this disparity. Silo bags International - for low cost on-farm storage of grainGastroschisis is a relatively uncommon condition that occurs in approximately 1 in 5,000 live births. ComplicationsView the sourcing details of the buying request titled Medical Silo Bag/ Infant Stoma Care Bag for Gastroschisis, including both product specification and requirements for supplier. 9% NaCl at the bottom to keep the environment moist. What's a Gastroschisis Silo? Gastroschisis is when a baby is born with the intestines sticking out through a hole in the belly wall near the umbilical cord. Warmer bed should be in flat position. The baby’s bowel pushes through this hole. REVISED: 19 November 2021. This allows gravity to help the intestine to slip back into the abdomen. Fetal gastroschisis is a congenital defect in a baby's abdominal wall that allows the infant's intestines to protrude through to the outside. This was the case in this instance, as the infant underwent operative reduction and closure on day 24. 05%). Placing a spring-loaded silo bag as a bedside procedure without anesthesia on newborns with severe gastroschisis whose viscera cannot be reduced primarily has increased the survival rate (94. Gastroschisis is the most common congenital abdominal wall defect. The incidence of stillbirth is approximately 5 percent. Gastroschisis is a congenital defect of the anterior abdominal wall resulting in evisceration of the intestines with exposure to amniotic fluid. The prognosis of infants with gastroschisis is largely dependent on the condition of the bowel at birth. The purpose of this meta-analysis was to compare short-term outcomes associated with primary fascial closure and staged repair with a silo in. 08. 2), eliminated the need for suturing and meant that the silo could be placed on an awake baby in the NICU. management outcome of gastroschisis using our improvised silo, and performing an extended right hemicolectomy. Ships Within 24 Hours. Surgery will relocate your baby's organs after birth. The silo is a bag that protects the bowels. This opening in the abdominal wall is usually small and located to the right of the umbilical cord's insertion point. Sell Unit EACH. Silo bags are synthetic, flexible silicone bags used to cover and protect the bowel of neonates born with gastroschisis. What Is Gastroschisis? Gastroschisis is when a baby is born with the intestines sticking out through a hole in the belly wall near the belly button. Therefore, in this article, we present a method for creating a preformed silo bag by utilising readily available disposable equipment in secondary or tertiary hospitals. The two primary methods are immediate closure (IC) or silo placement (SP). V1I0. 5cm diameter (fig1). 5–5. STAGED SILO REPAIR OF GASTROSCHISIS 487 Table 2. Gradually, the organs are squeezed by hand through the silo into the opening and returned to the body. by a 1. US $9-13 / Piece. 0001). 7%) silos were applied at cot side (no sedation, n = 93). List Price $729. mean birth weight was 2. 01 ± 0. Bowel loops were placed inside a surgical latex glove size 8 and the. (1) Background: The morbidity of gastroschisis is defined by exposure of unprotected intestines to the amniotic fluid leading to inflammatory damage and consecutive intestinal dysmotility, the viscero-abdominal disproportion which results in an abdomen too small to incorporate the herniated and often swollen intestine, and by associated. of patients) 1d 3 0 2d 1 0 3-5 d 0 2 silo were observed. Most babies only need one operation. To identify differences in outcome of infants managed with. Surgical strategies in complex gastroschisis. Methods: Records of babies with gastroschisis from 1994-2004 were reviewed. F. rate of primary facial closure (although in a delayed fash- 6. Gastroschisis is a birth defect in which an infant's intestines stick out (protrude) through a hole in the abdominal wall. Arch. Part Number Bentec Medical GR74089-05. Gastroschisis silo bag . Intestinal complications such as perforation and volvulus can occur and their management can be perplexing. 77(1. The only silo codes I come up with are the codes for gastroschisis ( 49605) and i do not believe that applies in this case. A 5-cm spring-loaded Silicone Ventral Wall Defect Silo Bag (Bentec Medical Inc. The care team gradually tightens the silo as the intestines return to normal size. The defect allows the baby’s. Every day, the silo is tightened and some of the. Any help would be greatly appericated. The significant fluid balance changes and heat loss from exposed intestines in gastroschisis require emergency surgical intervention to establish. Gastroschisis affects around 1 in 3,000 babies. For the staged reduction of gastroschisis and omphalocele Choose from bag openings with a wire spring encapsulated in silicone or a. Mychaliska ⁎ Section of Pediatric Surgery, Department of Surgery, The University of Michigan Medical School and The C. Early reports advocate for attempts for PC in gastroschisis infants. The opening can be small or large, and in some severe cases, the stomach and/or liver can also extend outside the body. 3. In the absence of standard silos, improvised ones were constructed from the amniotic membrane (3 cases), urine bag (4 cases), andBentec Medical GR74089-05 - BAG, SILO VENTRAL WALL DEFECT, 6CM TAPERED, EACH. PMCID: PMC7765881. 1 a–c). CITATION. 1%. Article Google. S. Use minimal tension in securement. 2%) staged closures. Infectious Complications Infectious Complication No. Bentec Medical Silicone Sheeting are selected by surgeons for many different procedures, including the construction of “chimneys” for neonates with gastroschisis or omphaloceles, reinforcement of wound or surgical incision closures and scar reduction. 5%) by staged silo repair, 14 (41. List Price $ 625. RECEIVED: 7 August 2021. There were no significant differences in mortality, sepsis, readmission, or days to full enteral feeds between IC patients and. o Antibiotics not necessary in the absence of culture positivesepsis or clinical instability or for silo presence. This defect causes the intestines (and sometimes stomach and/or liver) to exit the abdomen from a small hole, usually to the right of the umbilical cord, where the abdominal muscles and skin did not form. 3%. Babies of mothers under the age of 20 are at an increased risk. Gastroschisis is traditionally managed by emergency primary closure, with a temporary silo reserved for large defects unable to be closed primarily. 11 cm and a volume of 675 ± 7 mL. Often, the intestines don't fit in the belly because they're swollen. Gastroschisis and omphalocele. Use of a plastic hemoderivative bag in the treatment of gastroschisis. Am Surg. For example, we were told that gastroschisis affects roughly 1/5000 pregnancies. Sometimes, gastroschisis can be repaired surgically at birth. These conditions develop as a baby grows inside the womb. Primary closure (PC) is reduction and fascial closure; silo closure (SC) places viscera in a preformed-silo and reduces the contents overtime. This could make it hard for your baby to breathe if the intestines press against the lungs. Our multidisciplinary American and Ugandan team designed and bench-tested a low-cost (LC) silo that costs < $2 and is constructed from locally available materials. Currently, tertiary. The mortality rate of patients with gastroschisis is proportional to the income per capita in a given country, being 3. Bowel loops were placed inside a surgical latex glove size 8 and the edges of the cuff of the glove was sewn to margins of the abdominal wall defect with continuous 3-0 polypropyleneDOI: 10. Davis, Bradley J. Spring stays inside the peritoneal cavity and keeps the silo in place. 63. doi: 10. Silo bags are expensive, and different sizes are needed depending on the gastroschisis size. Miranda ME, Tatsuo ES, Guimaraes JT, Paixão RM, Lanna JC. Gastroschisis. Despite advances in the surgical closure of gastroschisis, consensus is lacking as to which method results in the best patient outcomes. Closure methods in gastroschisis (2018). The silo is a bag that protects the bowels. Silos are indicated for the protection of theSilo bags are expensive, and different sizes are needed depending on the gastroschisis size. Putting the intestines back into the belly with a silo. thdonghoadian. In one-third to one-half of babies with gastroschisis, the belly is not big enough to put all the bowels back right away. S. Kim, SS. Placing a spring-loaded silo bag as a bedside procedure without anesthesia on newborns with severe gastroschisis whose viscera cannot be reduced primarily has increased the survival rate (94. allow the intestines to slowly move into the belly. 36555/36556 CVC-tunneled <5/>5. Currently, tertiary hospitals in low-income countries experience great difficulty in purchasing these bags. Our transparent, soft,. They concluded analgesia for reduction is "safe if strict selection criteria are adhered to. A silo is a “bowel bag” that attaches to a bar that suspends above the baby so that the exposed organ can slowly enter into the body via gravity. let the water move out of the intestines so they shrink to normal sizeBackground Gastroschisis mortality in sub-Saharan Africa (SSA) remains high at 59–100%. The post- Gastroschisis happens in as many as 1 out of 2,000 births. The total cost is approximately US $10 for each 'silo' bag. Objective To describe one year outcomes for a national cohort of infants with gastroschisis. The Bentec Silo Bag provides a sutureless approach that can be placed in the NICU when primary reduction & closure of these. 565-574, 10. Gastroschisis incidence rates increased from 0. In LIC, mortality was reported as >75% by 61% delegates and 50-75% by 33%, compared to <25% by 100% of HIC delegates ( P < 0. Eviscerated organs are reduced by gravity and with additional manual pressure and the silo volume is gradually reduced over a period of typically 5–7 days. doi: 10. A silo is a covering placed over the abdominal organs on the outside of the baby. If your baby has not delivered by 38 weeks, we will “induce” the pregnancy to cause delivery because there is some evidence that the last few weeks of pregnancy may be more dangerous for babies with gastroschisis. 5 ) which require suturing of edge of ba g to fascia under. Results: Thirty-nine cases were analyzed. Gastroschisis silos are often unavailable in sub-Saharan Africa (SSA), contributing to high mortality. PMID: 33348575. (inches. Bentec has been. Gastroschisis is a paraumbilical, full-thickness abdominal wall defect associated with protrusion of the bowel through the defect. REFERENCES: 1 Puri A, Bajpai M. So a mesh sack called a silo is stitched around the borders of the defect, and the end of the silo is hung above the baby. Gastroschisis traditional management is the primary operative closure surgery (POCS), but the sutureless silo approach (SSA), a novel alternative, gains wide acceptance in the developed countries and across nations. "Multidisciplinary Development of a Low-cost Gastroschisis Silo - Free download as PDF File (. Results: Urine collection bags and female condom rings were chosen as the most accessible materials. Reduction of gastroschisis & omphalocele without anesthesia at bedside. S. A congenital condition is a condition that your baby is born with. H. Bentec Medical has received the CE certification for its Silo Bag products on April 18, 2021. Some studies have shown gastroschisis managed with a silo and delayed closure 1 3 increased the neonate's time on the ventilator, time to initiate enteral feeding, time to full enteral feeding. Silo Bags are indicated for the protection of the exposed bowel in infants. The disposable equipment required includes a 200- or 500-ml saline or blood bag, 16- or 18-Fr silicone/latex Foley catheter, Opsite® and 2-0 silk suture. One hundred fifty infants were included, and 139 (92. If so, the surgeon usually arranges the intestines in a bag called a silo to: let the water move out of the intestines so they shrink to normal size. HISTORY. Gastroschisis silo bag A sterile, synthetic polymer bag intended to contain and isolate the protruding intestine of a neonate with. Overview. 223. 3 Kunz SN, Tieder JS, Whitlock K, Jackson JC, Avansino JR. The intestine is placed inside the silo bag and the ring is placed under the fascia. Over next few days, bowel is gradually reduced and eventually, abdominal closure is. Product Code. 2008;21:648-51, doi: 10. Gastroschisis: a simple technique for staged silo closure. The abdomen was already quite soft and the bag already quite loose, but we just made it. We performed a systematic review and meta-analysis of the literature comparing use of a PFS with alternate treatment strategies. Gastroschisis is a birth defect where your baby is born with their organs outside of their body. 50):. Complex gastroschisis was diagnosed in. This study compared the management outcome of gastroschisis using our improvised silo, and performing an extended right hemicolectomy. This happens because a hole was left in the abdominal wall when it formed during pregnancy. Ships Within 24 Hours. Gastroschisis refers to a rare birth problem that is characterized by a specific defect affecting the anterior portion of the abdominal wall, in which the abdominal intestinal contents are noted to be freely protruding outside a baby’s body. 15. Mychaliska ⁎ Section of Pediatric Surgery, Department of Surgery, The University of Michigan Medical School and The C. This allows gravity to help the intestine to slip back into the abdomen. 800. We designed a single institution pilot study to assess whether simulation-based training (SBT) for placement of a silastic silo. 1%. Often, the intestines don't fit in the belly because they're swollen. The opening is most often on the right side of the baby’s belly. 026, Chi. A silo can be slowly tightened to help the intestines shrink and go back into the belly. Key findings in gastroschisis (see Fig. If an omphalocele or gastroschisis is too large to impair immediately what will they do? Click the card to flip 👆. Thirty four neonates with gastroschisis were included, 24 (70. Peds unit 2 GI and GU. But silo bags cost $240 per bag, making this treatment difficult to access; so, in Uganda, the survival rate for gastroschisis is around 0%. The truth is, today, it is closer to 1/2500 pregnancies. Office: 714-364-4050. Put the baby's lower half and the intestines in a special plastic bag to keep the intestines from losing too much water and to reduce heat loss. Babies with gastroschisis often undergo surgery to close the abdominal wall defect the day they are born. pediatric surgery. Disposable Silo Bag for Gastroschisis, Find Details about Surgical Instrument, Medical Device from Disposable Silo Bag for Gastroschisis - Microcure (Suzhou) Medical Technology Co. Mustafa Kabeer is a board-certified pediatric surgeon at CHOC, performing all types of general surgery and specializing in pectus excavatum (sunken chest), lung resection, hernia and robotic surgery. 1. 9%, 1. The amount of abdominal contents outside the baby varies from very small - just a few loops of bowel - to quite large, involving most of the intestines and stomach. There were 12 patients who fell into the urobag group, 6 patients diagnosed as having gastroschisis and ruptured omphalocele each. Materials and methods: Patients were randomized to PC versus DC. SB06. Both omphalocele and gastroschisis are often first diagnosed through prenatal sonography . The herniated bowel at the gastroschisis site was reduced with the aid of the silo by 96 hours and the fascia then closed primarily. 2), urine bag (4 patients), and latex gloves (9 patients) giving a total of 16 patients managed with improvised surgical silos (Silo group). While the infant is in the womb, the intestines float free in the amniotic fluid (bag. Mortality rate was 37. So a mesh sack called a silo is stitched around the borders of. 8. In gastroschisis, the abdominal wall does not form completely so the. This condition occurs when an opening forms in the baby’s abdominal wall. 2%) closures were primary and six (18. Hawkins and. Putting the intestines back into. Spring-Loaded Silicone Silo Bag - 10cm Opening Diameter. SILO bags: a valid support for newborns with gastroschisis. Soft, Pliable, Transparent Material Range of Sizes & Configurations Spring-Loaded Since 1997, clinicians around the world have used the Bentec Silo Bag for staged reductions of congenital ventral wall defects. 0001) and shorter time to full feeds (p=0. The management of gastroschisis is a challenging problem for pediatric surgeons the world over. In one-third to one-half of babies with gastroschisis, the belly is not big enough to put all the bowels back right away. Gastroschisis is a ventral abdominal wall congenital defect with bowel herniation outside the abdominal cavity. allow the intestines to slowly move into the belly The care team gradually tightens the silo as the intestines return to normal size. A plastic material is wrapped around the intestines outside the body. 26. About 1,800 babies born in the United States are born with gastroschisis. Placing a spring-loaded silo bag as a bedside procedure without anesthesia on newborns with severe gastroschisis whose viscera cannot be reduced primarily has increased the survival rate (94. 5%) were treated by primary closure, 10 (29. Pediatr Surg Int monitoring in newborns with gastroschisis, omphalocle, and diaphrag- 15:442-444, 1999 matic hernia.