ABSTRACT
Ambrose Paré, the famous French surgeon, first described an infant with omphalocele in 1634. Although small omphaloceles were subsequently successfully repaired, there were few reported survivors of larger abdominal wall defects until the 1940s, when Gross described a two-stage closure of an omphalocele using skin flaps followed by ventral hernia repair. Further advancement in the treatment of massive omphalocele defects occurred when Schuster devised an extracelomic ‘pouch’ to house eviscerated bowel temporarily. This was later modified by Allen and Wrenn, who devised the additional innovation of staged reduction of abdominal contents to allow gradual enlargement of the abdominal cavity. The development of total parenteral nutrition in the 1960s allowed vigorous nutritional support of infants with abdominal wall defects, in whom a period of 1-3 weeks of intestinal dysfunction is expected after the operation. The basic principles of occasional non-operative therapy, primary closure when possible, and staged reduction with a temporary Silastic ‘pouch’, remain the mainstays of contemporary therapy for these congenital defects.
