Hidemi Takasu1, Yoshio Watanabe. 1. Division of Pediatric Surgery, Aichi Children's Health and Medical Center, Obu, Aichi 474-8710, Japan. hidemi_takasu@mx.achmc.pref.aichi.jp
Abstract
PURPOSE: In cases of large umbilical hernias, standard surgical techniques have proven inadequate for diminishing the diameter of the umbilicus. We have modified the 3- and 4-triangular-skin-flap techniques to diminish the diameter of the umbilicus and achieve a cosmetically acceptable umbilicus. MATERIALS AND METHODS: Umbilicoplasty was performed in 149 children (median age, 2.5 years; range, 3 months-10 years) between 2003 and 2008. We created 4 skin flaps 1.5 cm in length on the umbilicus and excised the cranial diamond-shaped skin flap. After closure of the fascial defect, the diameter of the umbilicus was diminished by suturing the opened cranial part of the diamond-shaped skin flap vertically. The tips of the 3 remaining flaps were then anchored to the closed fascia. RESULTS: Postoperatively, granulation tissue occurred in 18 cases (12%), transient erythema of a flap in 15 cases (10%), and bulging of a skin flap in 15 cases (10%). These complications were reduced by suturing adjoining skin flaps. No recurrent hernias were encountered. The postoperative umbilical appearance was satisfactory in all cases. CONCLUSION: This surgical technique is effective for diminishing the diameter of the umbilicus and creating a cosmetically acceptable shaped umbilicus, even for large umbilical hernias.
PURPOSE: In cases of large umbilical hernias, standard surgical techniques have proven inadequate for diminishing the diameter of the umbilicus. We have modified the 3- and 4-triangular-skin-flap techniques to diminish the diameter of the umbilicus and achieve a cosmetically acceptable umbilicus. MATERIALS AND METHODS: Umbilicoplasty was performed in 149 children (median age, 2.5 years; range, 3 months-10 years) between 2003 and 2008. We created 4 skin flaps 1.5 cm in length on the umbilicus and excised the cranial diamond-shaped skin flap. After closure of the fascial defect, the diameter of the umbilicus was diminished by suturing the opened cranial part of the diamond-shaped skin flap vertically. The tips of the 3 remaining flaps were then anchored to the closed fascia. RESULTS: Postoperatively, granulation tissue occurred in 18 cases (12%), transient erythema of a flap in 15 cases (10%), and bulging of a skin flap in 15 cases (10%). These complications were reduced by suturing adjoining skin flaps. No recurrent hernias were encountered. The postoperative umbilical appearance was satisfactory in all cases. CONCLUSION: This surgical technique is effective for diminishing the diameter of the umbilicus and creating a cosmetically acceptable shaped umbilicus, even for large umbilical hernias.
Authors: Andrea Sisti; Maria T Huayllani; Daniel Boczar; David J Restrepo; Gabriela Cinotto; Xiaona Lu; Roberto Cuomo; Luca Grimaldi; Giuseppe Nisi; Antonio J Forte Journal: Aesthetic Plast Surg Date: 2020-10-23 Impact factor: 2.708