Objectives: This study aimed to evaluate the outcome of concomitant
umbilical hernial repair and abdominoplasty in multiparous obese
females.
Patients & Methods: After application of inclusion criteria, the study
included 26 multipareous females with mean age of 30.2±5.3 years,
number of children of 3.2±1.1 child, body mass index (BMI) of 32±2
kg/m2 and preoperative waist circumference (WC) was 127.6±9.9 cm.
Operative procedure included open excisional lipectomy with
preservation of the umbilical cicatrix with surrounding skin and a leash of
blood supply, mesh repair of the umbilical hernia, plication of both rectus
sheaths with adjustment of flanks to reduce WC and wound closure after
suction drainage. Umbilical preservation outcome, postoperative (PO)
WC measurements were taken at one and 6 months after surgery. The
frequency of recurrent umbilical hernia was reported at the end of followup
for 6 months.
Results: Total operative morbidity was 19.2%; 2 patients (7.7%) had
wound infection; one patient (3.8%) had wound seroma, all had
responded to conservative treatment and 2 patients (7.7%) had wound
end dog-ear that was corrected under local anesthesia as outpatient
procedure. Twenty patients had well-sited, normally appearing umbilicus
with healthy skin and good vascularity with an umbilical preservation
success rate of 77%. Six patients had partially impaired vascularity
manifested as spots of mild discoloration in 2 patients, superficial skin
sloughing of the umbilical edge skin in one patient and umbilical wound
infection in one patient. These two patients responded to conservative
treatment without wound dehiscence. In 3 patients the umbilicus was
slightly caudally shifted. WC estimated at one and 6-m PO showed
significant reduction compared to preoperative WC, but was significantly
wider compared to WC estimated at 1-m PO.
Conclusion: The applied procedure of abdominoplasty with umbilical
preservation after repair of umbilical hernia is a safe, effective procedure
with good aesthetic results and free of PO hernial recurrence.
Key words:Umbilical preservation,Abdominoplasty |
