Surgical Aftercare

Surgery - Aftercare

Your child will need to spend some time after the surgery in the intensive care unit (ICU) . Because infants are unable to properly regulate their temperature, they are placed in special beds that are kept warm. They will usually need oxygen and a breathing tube to help them breathe for a while. The breathing machine is referred to as a ventilator. This machine helps the baby breathe at the right depth and frequency for his or her age, allowing the infant to conserve energy for other functions. An infant that is struggling for air spends much energy on breathing, which slows the healing process.

Once the bowels are moving normally, feedings will be slowly started. Feedings are usually first done through a nasogastric tube so the infant does not need to use energy for sucking and swallowing. Sucking on a pacifier is avoided because this could cause the bowel to expand with air and slow down the healing process. Until the nasogastric tube is used, the infant will be fed intravenously. The intravenous line provides the infant with needed antibiotics, pain medication, and fluids.

Infants with an omphalocele may spend quite some time, perhaps several months, in the hospital before being discharged home. It may take them some time to learn to feed through normal infant sucking and swallowing. Their development may be delayed, and they may require help for months as they catch up to the physical and mental development that is normal for their age. If the parents do not live near the hospital, they should be encouraged to spend as much time with their infant as possible to ensure infant-parent bonding. When the repair is done in stages, it can be difficult for the parents to remain patient. The birth of a child with a birth defect can be quite emotionally difficult for the parents. Individuals trained to assist parents through this time should meet with them to provide information and support.

Risks

All surgery has risks, from the procedure itself as well as the anesthesia. Infection and bleeding are the two primary risks of surgery. Breathing problems and reactions to the anesthesics are the main risks from anesthesia. In addition to these standard surgical risks, an omphalocele repair has the associated risks of damage to the organs on the outside of the body, additional breathing problems from the added pressure inside the abdominal cavity when the contents are returned, infection of the abdominal cavity (peritonitis), and a slowing or paralysis of the bowels (paralytic ileus).

The expected results depend on many factors, including:

  • size of the omphalocele
  • degree of development of the abdominal cavity
  • presence and extent of other congenital defects
  • damage to or loss of intestinal tissue
  • whether the infant was full-term or premature at birth

Many omphaloceles can be completely corrected with excellent results. Source: Encyclopedia of Surgery

Complications

An omphalocele is diagnosed and usually treated at birth. Complications may arise, however, after returning home. Things to watch out for include: decreased bowel movements, changes in appetite, fever, greenish or yellow vomit and abnormal behavior changes.

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