A case report of surgical repair of cleft sternum in a child.

BACKGROUND: Sternal cleft is a rare congenital chest wall defect, occurring in only 1 in 100,000 live births, and very few cases have been described in the literature. Surgery is indicated to protect the heart and major vessels. This study provides a clinical case presentation and literature review of sternal cleft. METHODS: This is a review of a case presenting with chest wall defects. The patient underwent a primary cleft closure at Children's Hospital No. 2. All perioperative data were collected and presented. CASE PRESENTATION: A healthy 3-year-old girl was admitted to Children's Hospital No. 2 with an abnormal chest shape, observed by her mother. An inverted "U"-shaped defect of the sternum was visible, and the extent of the defect could be observed by chest X-ray and spiral computed tomography (CT) imaging of the chest. After the diagnosis was confirmed, the patient was prepared for primary closure surgery. We achieved primary closure, the patient discontinued oxygen 5 days after surgery, and the patient was discharged 14 days after surgery. CONCLUSION: Chest wall malformations can present with various phenotypes, although congenital sternal cleft is a rare anomaly. This defect is often asymptomatic. Depending on the size of the defect, a sternal cleft may be treated or monitored. The optimal treatment during early life is surgical repair to achieve primary closure.

A case series describing vacuum-assisted closure for complex congenital abdominal wall defects.

ABSTRACT: Giant omphalocele and large gastroschisis remain challenging issues faced by pediatric surgeons and neonatal intensivists. In this report, we presented 3 neonatal cases with complex congenital abdo-minal wall defects that were successfully treated with vacuum-assisted closure (VAC). Case 1 had a ruptured giant omphalocele and was treated with VAC for 24 days. She was successfully discharged at 78 days old. Case 2 had large gastroschisis that was unretractable using silo reduction. She was treated with VAC for 19 days and was succes-sfully discharged at 69 days old. Case 3 had large gastroschisis, and his defect had been closed using Gore-tex after silo reduction. VAC was applied for 14 days, and the baby was discharged at 67 days old. The VAC system can be effectively used to assist with visceral reduction, promote granulation tissue development, and skin epithelialization. This method represents a life-saving treatment for neonates with giant omphalocele and large gastroschisis.