Repair of a giant omphalocele defect using tissue expansion and Gore-Tex mesh following loss of durable repair with Alloderm: A case report
Bibliographic record
Abstract
Alloderm is commonly used in abdominal wall reconstruction, however its integrity can fail in the long term. We describe the repair of a giant omphalocele defect in a seven-year-old female who previously underwent an initial closure at birth using Alloderm, which stretched over time. A female infant underwent abdominal wall repair using Alloderm mesh to for a ruptured giant omphalocele in the context of local infection that prevented tissue expansion. While providing good initial coverage, the Alloderm stretched over time, resulting in a large persistent abdominal wall defect. The patient underwent attempted reduction using an abdominal binder with limited success. At 6.5 years of age, the patient underwent bilateral flank tissue expander and scar tissue mobilization to prepare for skin advancement. At 7 years of age, the patient underwent definitive abdominal wall reconstruction using Gore-Tex DualMesh with removal of the tissue expanders. Postoperative management included continued use of an abdominal binder and vacuum-assisted closure. At 4 years and 4 months after the reconstruction, the abdominal wall remains stable with good respiratory, alimentary, and digestive function. The patient continues to grow well and tolerate all physical activities, with no recurrent herniation. The tendency for Alloderm to stretch over time limits its utility for abdominal wall repair in giant omphaloceles. In our case, it did serve as a successful bridge to definitive closure in the context of active infection at birth.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".