The infant is usually placed in an incubator or radiant warmer so that temperature can be maintained Without clothing or covers that might irritate the CNS lesion. When an overhead warmer is used, the dressings over the defect require more frequent moistening because of the dehydrating effect of the radiant heat. Before surgical closure, the mvelomeningocele is kept from drying by the application ofa sterile, moist, nonadherent dressing. The moistening solution is usually sterile normal saline. Dressings are changed frequently (every 2 to 4 hours), and the sac is closely inspected for leaks, abrasions, irritation, and signs of infection. The sac must be carefully cleansed if it becomes soiled or contaminated. Sometimes the sac ruptures during delivery or transport, and any opening in the sac greatly increases the risk of infection to the CNS (Fig. 35-6, B). When an overhead warmer is used, the dressings over the defect require more frequent moistening because of the drying effect of the radiant heat.