Alloplastic Closure of Defects in Growing Organisms.

The importance of operative correction of congenital and acquired defects of the diaphragm has been well demonstrated by the numerous articles published on this subject over the past 30 years. The site and size of the diaphragmatic defect will seldom prevent primary closure; when it does, different methods of plastic repair can be employed (Gross, 1911; Sauerbruch, 1928; Rehn, 1919; Rives and Baker, 1942). Some have suggested muscle flaps for the closure, while others have tried to close defects by interposition of different organs. Monahan (1951) and Quenu and Herlemont (1953) independently initiated the use of synthetic material in diaphragmatic surgery, and these synthetics have been tried in animal and in clinical experiments. In contradistinction to the closure of abdominal and chest wall defects, the synthetic material for closure of diaphragmatic defect is in contact with body tissues only at its edge. Even if we assume that the lung in the chest, and the liver and omentum