ABSTRACT
Postoperatively, the patient should receive fluid and electrolyte management which takes into account a potentially diminished renal reserve. A circumferential wrap should encircle the lower extremities from ankles to mid-abdomen to ‘strap’ together the upper thighs to minimize pelvic tension and possible distraction of the closed pubic rami (Fig. 67.7). Suspension in a modified Bryant’s traction has also been reported.19 Staged closure of the omphalocele should follow in those cases with an applied prosthetic silo. The fecal stream should be collected by a stomal appliance and the perineum should be isolated either by temporary bladder or ureteral catheters or by permitting free drainage of urine onto the bladder exstrophied plate.
