Silver sulfadiazine as the topical treatment for giant omphalocele: a case report

Abstract

Background: Major omphalocele is defined as an abdominal defect greater than 5 cm with the presence of the liver and most parts of the bowel in the sac. The management remains challenging for pediatricians and surgeons with remarkably high mortality. Reports about topical agents/dressing used as escharotic therapy, such as silver sulfadiazine, povidone-iodine, topical antibiotics, or honey, have been published with different results. Continued application of a thick layer of silver sulfadiazine on the omphalocele surface is needed to promote eschar formation and neo-epithelialization. Case description: A term, 2700-gram newborn male infant presented with abdominal defect and herniated abdominal contents covered by a membranous sac containing liver that is widely known as omphalocele. A thick layer of silver sulfadiazine was applied repeatedly onto the omphalocele sac to promote epithelialization and successfully reduce the sac diameter. The patient showed a positive outcome as it reduced the omphalocele size after nine days. The patient family has been educated about the continued application of silver sulfadiazine. Although non-operative delayed treatment has lower mortality rates and better clinical outcomes, the patients should wait for the reconstruction surgery for a long time. Conclusion: Conservative treatment with silver sulfadiazine is safe and shows satisfying results to the giant omphalocele.