Proceso de atención de Enfermería en un paciente con gastroquisis. A propósito de un caso / Nursing care process in a patient with gastrochisis. Aproposs of a case

RESUMEN La gastroquisis, es un defecto congénito de cierre de la pared abdominal, en general justa a la derecha de la insertación normal del cordón umbilical en la pared del abdomen. Rara vez ocupa una posición especular a la izquierda del cordón umbilical; una cantidad variable de intestinos, y en ocasiones otros órganos abdominales se hernian, fuera de la pared abdominal, sin saco ni cobertura membranosa a diferencia del onfalocele. El Proceso de Atención de Enfermería, es el método científico de actuación de los profesionales de la Enfermería, vinculados a una base teórica que desarrollan habilidades analíticas que aplicadas en la práctica, repercuten en la mejoría de los pacientes. El objetivo de este trabajo es describir un caso poco frecuente de gastroquisis, y vincularlo al proceso de atención de Enfermería. Se trató de una recién nacida, sexo femenino, raza mestiza. Ingresó en la Sala de Terapia Intensiva del Hospital Pediátrico Provincial Eliseo Noel Caamaño de Matanzas con 5 horas de nacida. La vinculación de este caso con el Proceso de Atención de Enfermería permitió una atención integral al individuo enfermo, y desarrolló las habilidades prácticas de la asistencia de enfermería (AU).

ABSTRACT Gastrochisis is a congenital defect of the abdominal wall closure, generally just on the right of the umbilical cord normal insertion in the abdominal wall. It rarely occupies a specular position to the right of the umbilical cord; a variable amount of intestines, and sometimes other abdominal organs, are herniated outside the abdominal wall, without a sac or a membranous covering unlike the omphalocele. The nursing care process is a scientific method of nursing professionals behavior, on a theoretical basis, developing analytical skills that, applied in the practice, have repercussion on the patients´ improvement. Describing an infrequent case of gastrochisis, and linking it to the Nursing care process is the aim of this article. The patient was a mestizo female newborn who entered the Intensive Care Ward of the Pediatric Provincial Hospital "Eliseo Noel Caamaño" of Matanzas five hours after birth. Linking this case to the Nursing care process allowed the integral care of the sick person, and developed the nursing care practical skills (AU).

Fetal Surgery: Gastroschisis Model in Rabbits

This study was to develop a technique for creating gastroschisis by fetal surgery on a pregnant New Zealand white rabbit and to develop a technique for full-term delivery of a mature fetal rabbit after the repair of the abdominal wall incision in the fetal rabbit. The fetal surgery was done on the 24th or the 25th day of pregnancy and the experiment was divided into two parts: the creation of gastroschisis in the fetal rabbit and celiotomy-repair in the fetal rabbit. To creat gastroschisis, celiotomy and evisceration of the intes-tine in the fetal rabbit was made at both cornua on the 24th or the 25th day of pregnancy. After 6 days, a Caesarean section was done to deliver two gastroschisis fetal rabbits and two normal fetal rabbits. For the celiotomy-repair, celiotomy-evisceration and immediate repair of the fetal rabbit was made at both cornua on the 24th or the 25th day of pregnancy. After 6 days, a Caesarean section was done to deliver two experimental fetal rabbits and two normal fetal rabbits. Gastroschisis was successfully produced in 10 out of the 38 fetal rabbits operated on. Celiotomy-repair was done in 38 fetal rabbits. The abdominal wound was successfully repaired in 9 out of these 38 cases. Microscopically, inflammation or scarring was found neither at the gastroschisis wall margin nor at the repaired abdominal wound; however, fibroblast proliferation was found at the repaired abdominal wound. This result coincided with the general tissue finding of the fetal surgery. The conclusions are as follows: 1. By fetal surgery, experimental gastroschisis was created in fetal rabbits, and 2. The experimental abdominal wound was successfully repaired by surgery on the fetal rabbits.