In the operative correction of exomphalos major (omphalocele >5 cm), when primary closure is not feasible due to a giant defect, the preferred staged technique is:

• A Silo placement with gradual reduction (staged silo technique) ✓
• B Immediate GORE-TEX patch repair
• C Skin-only closure with delayed fascial repair
• D Escharotic agents to epithelize the sac followed by delayed repair

Explanation

For giant exomphalos where primary fascial closure would cause abdominal compartment syndrome, the staged silo (spring-loaded or sutured silo) technique is used: bowel/viscera are placed in a silastic silo and gradually reduced into the abdominal cavity over 5–10 days, then definitive fascial closure is performed. Escharotic agents (e.g., silver sulfadiazine or mercurochrome historically) are occasionally used for high-risk neonates not tolerating surgery, but the silo technique is the standard operative approach.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.