Faculty Collaboration Database

Conservative management of giant omphalocele with topical povidone-iodine and its effect on thyroid function. J Pediatr Surg 2010 Jun;45(6):1192-7

Date

07/14/2010

Pubmed ID

20620319

DOI

10.1016/j.jpedsurg.2010.02.091

Scopus ID

2-s2.0-77953831898 (requires institutional sign-in at Scopus site)   46 Citations

Abstract

PURPOSE: The aim of the study was to evaluate topical povidone-iodine as a bridge to delayed fascial closure of giant omphaloceles with emphasis on its effect on thyroid function.

METHODS: Newborns from a single institution with giant omphaloceles treated with topical povidone-iodine for a 10-year period were reviewed. Recorded data included sex, associated anomalies, length of stay, frequency of povidone-iodine application, thyroid function tests, frequency of laboratory draws, and thyroid supplementation administration.

RESULTS: Six neonates with giant omphaloceles were treated with povidone-iodine. Thyroid function testing occurred weekly as inpatients and monthly as outpatients, with abnormal values normalized by the subsequent laboratory draw. One patient demonstrated persistent hypothyroidism and subsequently died secondary to cardiac complications, but this infant's newborn thyroid screening suggested congenital hypothyroidism. Five patients remained euthyroid and ultimately achieved fascial closure without the need for a prosthetic implant. None of these patients had abnormal outpatient thyroid tests nor did they require thyroid hormone supplementation.

CONCLUSION: Topical povidone-iodine promotes escharification and epithelialization of the omphalocele sac. Because transient hypothyroidism may occur, thyroid function studies may guide inpatient therapy. After sac desiccation, systemic effects of iodine are minimal and thyroid supplementation is not necessary. Topical povidone-iodine is an effective initial strategy for giant omphaloceles and does not produce clinically significant hypothyroidism.

Author List

Whitehouse JS, Gourlay DM, Masonbrink AR, Aiken JJ, Calkins CM, Sato TT, Arca MJ

Authors

John J. Aiken MD Professor in the Surgery department at Medical College of Wisconsin
Casey Matthew Calkins MD Professor in the Surgery department at Medical College of Wisconsin
David M. Gourlay MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Administration, Topical
Anti-Infective Agents, Local
Female
Follow-Up Studies
Gestational Age
Hernia, Umbilical
Humans
Infant, Newborn
Male
Povidone-Iodine
Retrospective Studies
Severity of Illness Index
Thyroid Gland
Thyroid Hormones
Treatment Outcome