Abstract
Total umbilical defects may occur after surgeries such as tumour excision. As the umbilicus is a well-recognized landmark in the abdomen, various reconstruction methods have been reported. We report an immediate reconstruction of the umbilicus using two different subcutaneous pedicled flaps from the lower abdomen, away from the umbilicus and the continuous cranial side. In this procedure, the caudal half to two-thirds of the umbilical fossa is reconstructed with a subcutaneous pedicled flap harvested from the lower abdomen, away from the defect. The rest of the cranial side is reconstructed with a subcutaneous pedicled V–Y advancement flap, continuous with the defect. From December 2016 to November 2018, three cases of umbilicus defects were reconstructed using this procedure. The deep umbilical fossa was reconstructed with good results in all the cases, without major complications. Although this procedure has some limitations, it is simple and easy, and the outcomes are positive.
Level of evidence: Level V, Therapeutic
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Data Availability
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Dohi T, Kuribayashi S, Aoki M, Tosa M, Akaishi S, Ogawa R (2020) Combination therapy composed of surgery, postoperative radiotherapy, and wound self-management for umbilical keloids. Plast Reconstr Surg Glob Open 8:e3181. https://doi.org/10.1097/GOX.0000000000003181
Southwell-Keely JP, Berry MG (2011) Umbilical reconstruction: a review of techniques. J Plast Reconstr Aesthet Surg 64:803–808. https://doi.org/10.1016/j.bjps.2010.11.014
Joseph WJ, Sinno S, Brownstone ND, Mirrer J, Thanik VD (2016) Creating the perfect umbilicus: a systematic review of recent literature. Aesthet Plast Surg 40:372–379. https://doi.org/10.1007/s00266-016-0633-x
Sisti A, Huayllani MT, Boczar D, Restrepo DJ, Cinotto G, Lu X, Cuomo R, Grimaldi L, Nisi G, Forte AJ (2021) Umbilical reconstruction techniques: a literature review. Aesthet Plast Surg 45:1078–1096. https://doi.org/10.1007/s00266-020-01989-4
Bartsich SA, Schwartz MH (2003) Purse-string method for immediate umbilical reconstruction. Plast Reconstr Surg 112:1652–1655. https://doi.org/10.1097/01.PRS.0000086084.32830.72
Navysany S, Daigeler A, Dippel E, Löser C, Navysany S, Daigeler A, Dippel E (2013) Reconstruction of the umbilicus after malignant melanoma. J Dtsch Dermatol Ges 11:462–464. https://doi.org/10.1111/ddg.12087
Lee CL, Yang HJ (2021) The three-point crossover technique for immediate reconstruction of the umbilicus. Arch Plast Surg 48:175–178. https://doi.org/10.5999/aps.2020.01424
Omori M, Hashikawa K, Sakakibara S, Terashi H, Tahara S, Shibaoka Y, Kimura K, Sano K (2013) One-stage umbilicus reconstruction after resection of urachal cyst. Ann Plast Surg 71:93–95. https://doi.org/10.1097/SAP.0b013e318248b830
Vergara de la Campa L, Brinca A, Pinho A, Vieira R (2020) Neoumbiliconeoplasty with a vertical island pedicle flap. Actas Dermo-sifiliogr 111:899–902. https://doi.org/10.1016/j.ad.2020.02.005
Arai K, Yamashita K, Suda T, Ikeda K, Yamauchi M, Yotsuyanagi T (2012) Primary reconstruction of the umbilicus, using two rectangular subcutaneous pedicle flaps. J Plast Reconstr Aesthet Surg 65:132–134. https://doi.org/10.1016/j.bjps.2011.07.007
Purnell CA, Turin SY, Dumanian GA (2018) Umbilicus reconstruction with bilateral square “pumpkin-teeth” advancement flaps. Plast Reconstr Surg 141:186–189. https://doi.org/10.1097/PRS.0000000000003929
van de Kar AL, Kreulen M, van Zuijlen PPM et al (2007) The results of surgical excision and adjuvant irradiation for therapy-resistant keloids: a prospective clinical outcome study. Plast Reconstr Surg 119:2248–2254. https://doi.org/10.1097/01.prs.0000260751.20217.28
Dohi T, Kuribayashi S, Aoki M et al (2020) Combination therapy composed of surgery, postoperative radiotherapy, and wound self-management for umbilical keloids. Plast Reconstr Surg Glob Open 8:e3181. https://doi.org/10.1097/GOX.0000000000003181
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We want to thank Editage for the English language editing.
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SK conceived the idea of the study and drafted the original manuscript. KK supervised the conduct of this study. All authors reviewed the manuscript draft and revised it critically on intellectual content. All authors approved the final version of the manuscript to be published.
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This brief report included a small number of case series, and the ethics committee of our university decided that an ethics review was unnecessary. Nevertheless, all procedures involving human participants were conducted in accordance with the ethical standards of our institution and with the 1964 Helsinki declaration and its later amendments.
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Informed consent was obtained from all individual participants included in the study.
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Written informed consent was obtained from all patients in the outpatient department after surgery for publication of case details and accompanying images.
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Shogo Kasai, Hirokazu Shito, Reiko Asato, Ryogo Kuba, and Kazuo Kishi declare no competing interests.
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Kasai, S., Shito, H., Asato, R. et al. Two separate subcutaneous pedicled flaps for repair of total umbilical defects: a simple reconstruction technique. Eur J Plast Surg 46, 637–642 (2023). https://doi.org/10.1007/s00238-023-02064-2
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DOI: https://doi.org/10.1007/s00238-023-02064-2