to maintain constant gentle pressure on a reduced omphalocele until spontaneous closure. Clarence Visick described the first surgical repair of a ruptured omphalocele in 1873. After reduc­tion of the intestines, the skin was closed with wire sutures [5]. Shortly thereafter, Olshausen reported removal of the perito­neum and skin flap coverage over the defect. In the mid-twen­tieth century, Gross popularized staged closure for large omphaloceles with freeing and approximating of the skin over the intact sac. A second staged operation was then performed at 6–12 months of age [6]. However, secondary ventral hernia repairs were often complicated by adhesions between the bowel and skin. This observation led Schuster and others developing the use of a prosthetic Teflon patch fashioned into a silo in the initial operation to aid in the reduction of the viscera [7, 8]. Schwartz later described using Silastic sheeting sutured to form a sac with gradual daily reduction for gastroschisis and omphaloceles [9]. The development of a preformed Silastic silo (Dow Corning, Midland, MI) with a spring-loaded ring (Ben Tec, Sacramento, CA) in the 1990s revolutionized the ease and simplicity of staged reduction for gastroschisis [10]. The so-called paint and wait technique for large omphaloceles was first described in 1899 by Ahlfeld who used alcohol to produce an eschar and epithelialization [11]. Mercurochrome replaced alcohol as the agent of choice until the detrimental toxic effects of mercurochrome were described [12–15]. Hatch and Baxter [16] first reported the use and safety of silver sulfa­diazine for escharotic therapy in 1987. Silver sulfadiazine has since become the preferred topical agent for epithelialization [17]. Innovative methods to gradually reduce omphaloceles and increase abdominal domain include the use of tissue expanders and negative pressure wound therapy [18, 19].