Delayed traction assisted reconstruction of the abdominal wall in a school-age child with former giant omphalocele

Abstract Objectives Giant omphaloceles present a particular challenge in surgical management due to the pronounced abdominal–visceral mismatch and frequently associated comorbidities. Case presentation We report the case of a school-aged child following failed primary closure of a giant omphalocele in the neonatal period. Due to severe loss of domain and extensive adhesions, conventional reconstructive strategies were not feasible. A delayed abdominal wall reconstruction using a vertical dynamic fascial traction system (Fasciotens ® ) was performed to achieve gradual fascial approximation. Despite the need for temporary patch interposition, progressive domain adaptation allowed for subsequent definitive fascial closure. Conclusions This case demonstrates that traction assisted reconstruction can serve as a viable option within an individualized treatment strategy for delayed abdominal wall closure in selected pediatric patients.