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ARTIFICIAL
ABDOMINAL INTEGUMENT FOR NEONATES WITH CONGENITAL EVISCERATION
Indications for clinical use:
Tegmentum is used in cases of
neonates with congenital anomalies of abdominal integument. Such anomalies
are: hernia of the umbilical cord (Fig. 1) and congenital evisceration
(Fig. 2 & 3).
Both anomalies are detected in the prenatal period so that the treatment
tactics can be planned long before a baby is born.
As far as the first case is concerned, viscera are covered with amniotic
membrane, which leaves the choice of the surgical method to a doctor:
multi-stage surgical treatment is possible (e.g. using TEGMENTUM) in
a neonate, or conservative treatment, at first, postponing the surgery.
Congenital evisceration does not leave out such an alternative and the
operation ought to be carried out within the first few hours after the
birth. In neonates with relatively small weight of eviscerated intestinal
loops, and with not too well advanced pathological changes within their
wall such as inflammatory or ischaemic ones, it is possible to perform an
operation in one stage with simultaneous complete reconstruction of the
integuments. In other cases multi-stage treatment is the optimum solution.
In these cases artificial integument TEGMENTUM can be used.
Instructions for clinical use of TEGMENTUM:
In neonates destined, due to large volume of eviscerated organs or
small abdominal cavity, to undergo stages of an operation, the operative
instructions are as follows:
Stage One is suturing two laps of TEGMENTUM selected
according to size together with the rectus muscle to the edges of
peritoneum, which is followed by suturing each of them centrally – a slight
tension should be applied (Fig. 4 & 5).
The surface covered with polyurethane is placed in the face of peritoneal
cavity. Increase in intra-abdominal pressure in neonates as a result of
translocation of viscera into the abdominal cavity is detected by taking
the blood pressure in the aorta, urinary bladder or stomach.
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Fig 4
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Fig 5
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Stage Two and the ones that
follow (optional) mean gradual reduction of the TEGMENTUM sack size
every two or three days – with the intestines being gradually placed in a
neonate's abdominal cavity (Fig. 6). Reduction of the sack size results
from making a new suture line between the two laps of TEGMENTUM.
The final stage, performed when all the intestines are already inside the
neonate's abdominal cavity, is removing the fragments of TEGMENTUM
that are left, to perform complete reconstruction of a neonate's integument
(Fig. 7 & 8 ).
Technical characteristics:
TEGMENTUM is made of 100% polyester knit covered by a layer of
medical polyurethane.
Size:
(20 x 10) cm – (2 pcs packed together)
water permeability: 0 ml/cm˛/min with P=120 mmHg
TEGMENTUM is packed in hermetic double troughs and then put into a
carton box.
TEGMENTUM is sold as a sterile medical material. Colored marker on
tubes and on carton indicates radiative sterilization performed on the
material.
TEGMENTUM should be stored in dry, airy rooms in temperature 10° to
25 °C. The packages ought to be protected against mechanical damage,
sunlight, acid vapours, organic solvents, etc.
The product is recommended by:
Prof. Andrzej Chilarski
Instytut Centrum Zdrowia Matki Polki – Pediatric Surgery Clinic
ul. Rzgowska 281/289
93-338 Łódź
POLAND
Tel.: +48 42 643 21 36
Fax: +48 42 646 62 78
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