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Thursday, November 19, 2009
Snow Cone Belly
As we mentioned in the previous post, when Dr. Scaife performed Nathan's hernia repair, he discovered that all of Nathan's insides that he had taken out of his chest (liver, stomach, intestines) didn't fit into his abdomen. Since they had never been in there in the first place, his abdomen hadn't grown to fit them.
As a result, Dr. Scaife temporarily housed a portion of Nathan's "guts" in a surgical silo, a polypropylene mesh covered on both sides with a sterile transparent adhesive film that is constructed right there in the operating room. The silo is sterile, soft, flexible, sturdy, internally smooth, provides a reasonable barrier, and allows visibility of the bowel. The silo is inserted to an open wound in the patient's abdomen and "reduced" as the patient tolerates. The patient is also given a large number of antibiotics to prevent infection since the silo is in an open wound.
However, because Nathan was still on ECMO, the silo posed a another potentially dangerous problem in addition to possible infection:
Patients on ECMO are given blood thinners to help prevent the ECMO machine from clotting. However, the blood thinners also prevented Nathan's wound from clotting, meaning that it was constantly bleeding. A a result, Nathan's silo was heavily bandaged with gauze. The gauze was replaced as needed as it became saturated with blood. He also received regular blood transfusions to replace the blood he was losing.
But with all the gauze, there were times that Nathan's tummy looked like a giant snow cone. Hence, we called him our Snow Cone Belly Baby while we waited for the day he would come off the ECMO.
**For those brave souls, you can view pictures of the uncovered silo, by clicking here. But I caution you, they are NOT for the faint of heart or stomach!