SIMULTANEOUS ADVANCEMENT FLAP UMBILICOPLASTY AND OMPHALOCELE REPAIR

Umbilical reconstruction commonly is an adjunct used after repair of congenital abdominal wall defects. Here, I 
describe a technique of umbilicoplasty for newborns with small and medium sized omphalocele, and compare the results with the normal neonatal umbilical anatomy. After reducing the contents and fascial closure, 5 newborns underwent 
umbilicoplasty performed by advancing bilateral skin flaps including creation of an umbilical skin collar. The umbilical 
collar height, circumference, and distance from the xiphoid with respect to the pubis (ratio of xiphoid-umbilicus distance to xiphoid-pubis distance or XU: XP) were recorded and referenced to the normal umbilical anatomy in additional 24 newborns (age 1 to 30 days [mean, 12 days]). After umbilicoplasty, all infants had a near normal appearing umbilicus (collar height, 0.7 ± 0.2 cm and circumference, 5.1 ± 1.3 cm) compared with normal umbilical anatomy (collar height, 1 ± 0.25 cm and circumference 4.5 ± 1.2 cm). However, after umbilicoplasty, the neoumbilicus was positioned slightly more cephalic (XU: XP = 0.61 ± 0.05) compared with normal (mean XU: XP, 0.67 ± 0.07). No major complications have occurred; minor complications included delayed wound healing in one case and decreased umbilical depth in one infant. All of the parents have been satisfied with the results of umbilical reconstruction.