From the Department of Plastic Surgery, Medical College of Wisconsin; Columbia-St. Mary's Hospital System; and Zablocki VA Medical Center.
Plast Reconstr Surg. 2021 Jan 1;147(1):98e-102e. doi: 10.1097/PRS.0000000000007503.
Umbilical reconstruction is a procedure with widespread indications in the setting of congenital or postsurgical loss. Reconstruction of the umbilicus when no remnant of the natural umbilicus is present is also called neoumbilicoplasty. Numerous neoumbilicoplasty techniques have been published, including cartilage grafts, full-thickness skin grafts, and multiflap reconstruction. No consensus has been reached regarding an optimal technique, and many procedures involve complicated designs with small flaps that are difficult to reproduce or explain. The authors divide patients into three types depending on the thickness of the adipose layer of the abdomen. With appropriate patient selection and minor variations depending on patient type, the technique can be applied to all patients. The umbilicus is marked in the appropriate position. Local anesthesia is infiltrated, and the area beneath the skin is defatted. The dermis is then applied to the underlying fascia with a superior shift. The authors describe the technique and its variations and present one illustrative case with additional supplemental digital content. The authors have gone through a progression of techniques to find a simple surgical method yielding consistently reproducible results with minimal complexity, limited morbidity, and an aesthetic final outcome. The authors believe that the technique described here achieves those goals. It can be performed under local anesthetic and with a simple occlusive dressing so that the patient can go on with most of his or her daily activities. There is no scar to suggest a surgical procedure, and patients are extremely happy with the aesthetic outcomes.
脐部重建术在先天性或后天性脐部缺失的情况下有广泛的适应证。当没有天然脐部的残余时，重建脐部也称为新脐成形术。已经发表了许多新脐成形术技术，包括软骨移植物、全厚皮片和多瓣重建。目前尚未就最佳技术达成共识，许多手术涉及到带有小皮瓣的复杂设计，这些皮瓣难以复制或解释。作者根据腹部脂肪层的厚度将患者分为三种类型。通过适当的患者选择和根据患者类型的轻微变化，该技术可适用于所有患者。在适当的位置标记脐部。局部浸润麻醉，并去除皮肤下的脂肪。然后将真皮向上移位到下面的筋膜上。作者描述了该技术及其变化，并通过附加补充数字内容呈现了一个说明性病例。作者已经经历了一系列技术，以找到一种简单的手术方法，该方法具有最小的复杂性、有限的发病率和美观的最终结果，能够始终如一地产生可重复的结果。作者认为这里描述的技术达到了这些目标。它可以在局部麻醉下进行，并用简单的闭塞敷料进行，以便患者可以继续进行大部分日常活动。没有疤痕表明进行了手术，患者对美学结果非常满意。
