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Related Experiment Videos

Circumumbilical versus transumbilical abdominal incision.

T R Paes1, D L Stoker, T Ng

  • 1Department of Surgery, East Surrey Hospital, Redhill, UK.

The British Journal of Surgery
|September 1, 1987
PubMed
Summary

Transumbilical versus circumumbilical midline abdominal incisions show no significant differences in wound infection or incisional hernia rates. Avoiding the umbilicus in abdominal surgery is unnecessary and may cause scar asymmetry.

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Area of Science:

  • Abdominal Surgery
  • Surgical Incisions
  • Wound Healing

Background:

  • Midline abdominal incisions are common surgical approaches.
  • The umbilicus is often avoided in midline incisions, creating a circumumbilical approach.
  • The clinical significance of avoiding the umbilicus in midline abdominal surgery is not well-established.

Purpose of the Study:

  • To compare the incidence of wound infection and incisional hernia rates between transumbilical and circumumbilical midline abdominal incisions.
  • To evaluate any potential surgical difficulties or cosmetic outcomes associated with each incision type.

Main Methods:

  • A prospective randomized trial involving 115 patients undergoing midline abdominal surgery.
  • Patients were randomized to either a transumbilical incision (n=58) or a circumumbilical incision (n=51).

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  • Wound infection and incisional hernia rates were assessed, with a minimum one-year follow-up for hernia assessment.

    • Main Results:

    • No statistically significant difference in wound infection rates was observed between the transumbilical and circumumbilical groups.
    • Incisional hernia rates were comparable between the two groups after at least one year of follow-up.
    • The transumbilical approach did not present any surgical difficulties, while the circumumbilical approach occasionally led to scalpel blade slewing and scar asymmetry.

    Conclusions:

    • The practice of avoiding the umbilicus in midline abdominal incisions offers no discernible benefit regarding wound infection or incisional hernia rates.
    • Transumbilical incisions are a safe and effective alternative to circumumbilical incisions, potentially offering better cosmetic outcomes.
    • Surgeons can confidently utilize transumbilical incisions without compromising patient safety or surgical outcomes.