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The umbilicus in gastroschisis: aesthetic considerations

J Bowen1, D Wilcox, A Bianchi

  • 1Neonatal Surgical Unit, St. Mary's Hospital, M13 OJN, Whitworth Park, Manchester, UK.

Pediatric Surgery International
|September 24, 2013
PubMed

Insights

Preserving the umbilical cord attachment (UCA) in gastroschisis (GS) is feasible and beneficial. This technique, using umbilical cord capping, results in a normal abdominal wall without additional scarring for infants with gastroschisis.

Area of Science:

  • Pediatric Surgery
  • Neonatal Care
  • Congenital Abnormalities

Background:

  • Gastroschisis (GS) is a congenital defect requiring surgical intervention.
  • Preservation of the umbilical cord attachment (UCA) is not standard practice in GS management.
  • Current methods may result in abdominal wall scarring and altered umbilical appearance.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of preserving the UCA in infants with gastroschisis.
  • To assess the efficacy of umbilical cord capping for reconstruction.
  • To determine if UCA preservation impacts abdominal wall integrity and cosmesis.

Main Methods:

  • Prospective study of 36 infants diagnosed with gastroschisis.
  • Implementation of UCA preservation technique in all cases.
  • Utilized umbilical cord capping for abdominal wall reconstruction.
  • Monitored for complications such as cellulitis and umbilical weakness.

Main Results:

  • UCA preservation was consistently achievable in all 36 infants.
  • Umbilical cord capping resulted in a normal abdominal wall and umbilicus without additional scars.
  • Mild cellulitis in 3 infants resolved with antibiotic treatment.
  • Initial umbilical weakness in 7 infants did not necessitate further surgical intervention.

Conclusions:

  • Preservation of the UCA should be a standard component of surgical technique for all gastroschisis cases.
  • Umbilical cord capping alone provides excellent cosmetic and functional reconstruction.
  • This approach minimizes scarring and achieves a natural-looking abdominal wall and umbilicus.

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