Supraumbilical pyloromyotomy: a unique indication for antimicrobial prophylaxis

Versatility of the circumumbilical incision in neonatal surgery

“…The use of the circum-supraumbilical approach for pyloromyotomy [5][6][7] has led to a realisation of its potential for the management of many ''routine'' abdominal operative procedures in the neonate, as well as in oncological surgery [5][6][7][8][9]. Of particular relevance is the safe exposure of the intraabdominal contents and the ability to deliver bowel through the wound, such that all procedures are performed safely under full vision.…”

Circumumbilical pyloromyotomy in the era of minimally invasive surgery

“…This occurrence has been documented for both supraumbilical and laparoscopic pyloromyotomies, with a wound infection rate as high as 16% and 22%, respectively [15,16]. Therefore, some authors have speculated that circumumbilical pyloromyotomy may delineate a unique indication for antibiotic prophylaxis because the umbilicus of a young infant represents an area of increased susceptibility to wound infections [14,17]. In our experience, only 1 of the 5 wound infections progressed to abscess formation and required incision and drainage, whereas the remaining 4 infections were characterized by minor and localized erythema.…”

The Cross-technique for single-incision pediatric endosurgical pyloromyotomy

“…Another study described an infraumbilical approach [18] with a mean operating time of 28 min and one duodenal perforation in 14 cases. One of the disadvantages of open pyloromyotomy through an umbilical incision has been a relatively high wound infection rate between 5.7 and 7.0% [19][20][21]. Also, because the incision must be at least as long as the hypertrophied pylorus (a length of 16 mm is generally used for sonographic diagnostic purposes), it is markedly bigger and more visible than the incision for SIPES pyloromyotomy.…”