, Volume 30, Issue 4, pp 407-411
Date: 09 Feb 2014

Non-operative management of giant omphalocele with topical povidone-iodine and powdered antibiotic combination: early experience from a tertiary centre

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Abstract

Purpose

The aim of the study was to evaluate topical povidone-iodine and topical powdered antibiotic combination (Polymyxin, Bacitracin and Neomycin) in initial non-operative management with delayed closure of the defect of giant omphaloceles.

Methods

A prospective study was conducted between July 2010 and June 2013 including all neonates with giant omphalocele without signs of intestinal obstruction. All cases were managed by daily application of povidone-iodine (5 % solution) followed by spraying topical powdered antibiotic combination to promote eschar formation and eventual epithelialisation. Record was made of sex, associated anomalies, length of stay, and thyroid function tests.

Results

Twenty-four neonates with giant omphaloceles were treated with topical povidone-iodine and topical powdered antibiotic combination. No sac ruptures were observed in our series. All patients had a normal thyroid function test at presentation and after 10 days of initiation of treatment. Six patients have undergone delayed repair.

Conclusion

Topical povidone-iodine and powdered antibiotic combination promotes more rapid escharification and epithelialisation of the omphalocele than povidone-iodine alone. We also hypothesise that combination minimises the chances of hypothyroidism associated with use of povidone-iodine alone.