The Importance of Umbilical Blood Supply and Umbilical Delay in Secondary Abdominoplasty: A Case Report

Parsa, Fereydoun Don; Cheng, Justin; Hu, Michael S.; Kim, Leslie; Castel, Nikki; Parsa, Alan A.

doi:10.1093/asj/sjy003

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…72 Similarly, the blood supply to the umbilicus may be altered due to transection of the umbilical stalk or compression of the stalk by a large umbilical hernia. 73 In these cases, the surgeon must take extra measures to minimize the risk of umbilical necrosis during the secondary abdominoplasty. Parsa et al found success in delaying the umbilicus 2 weeks prior to secondary abdominoplasty.…”

Section: Lower Trunkmentioning

confidence: 99%

“…This measure augments the umbilical blood supply of the underlying subcutaneous fat and fascia, providing the best chance of umbilical survival. 73 Should patients present with umbilical necrosis following primary abdominoplasty or flap delay, a neoumbilicus can be reconstructed during secondary abdominoplasty. 74 Secondary liposuction may be used as a standalone or adjuvant therapy for treating soft-tissue excess.…”

Section: Lower Trunkmentioning

confidence: 99%

“…77 Selecting the new positioning of the umbilicus is heavily dependent on the native location of the umbilicus, the amount of surrounding abdominal laxity, and the status of its vascular supply. 73,75 In patients with a viable umbilical stalk and sufficient skin laxity, the umbilicus can be transposed via secondary abdominoplasty, though a vertical scar will be necessary should there be significant cranial transposition of the umbilicus during the procedure. 25 Additionally, patients with a high-riding umbilicus may have their umbilicus "floated" inferiorly, though this allows for shorter transposition than traditional abdominoplasty.…”

Section: Lower Trunkmentioning

confidence: 99%

“…25 Additionally, patients with a high-riding umbilicus may have their umbilicus "floated" inferiorly, though this allows for shorter transposition than traditional abdominoplasty. 73,75 A neoumbilicus may also be created in cases of disfigurement or absence of the umbilicus due to previous compromise from surgery. This new umbilicus is formed in the ideal location from neighboring abdominal skin and soft tissue.…”

Section: Lower Trunkmentioning

confidence: 99%

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Avoidance and Correction of Deformities in Body Contouring

et al. 2021

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Body contouring procedures are highly impactful because of their potential to improve a patient's quality of life. These procedures, particularly when performed on patients following massive weight loss, may require secondary intervention to treat residual contour abnormalities. Presently, there is a paucity of information in the literature detailing the avoidance and correction of body contouring deformities. Herein, we will discuss the management of patients seeking revisional body contouring procedures.

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Section: Lower Trunkmentioning

confidence: 99%

Section: Lower Trunkmentioning

confidence: 99%

Section: Lower Trunkmentioning

confidence: 99%

Section: Lower Trunkmentioning

confidence: 99%

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Avoidance and Correction of Deformities in Body Contouring

et al. 2021

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“…8 However, DFU patients are not the only ones who experience failure in wound healing, necrotic tissue accumulation, and tissue excision/reconstruction. 9 Ulcers and amputations have profound quality-of-life consequences because of diminished physical function, loss of employment/income, emotional suffering, including depression, and social isolation. The problem is that there have been no reliable therapeutic approaches for the complex problem of refractory wounds with increasing necrotic tissue, resulting in amputations.…”

Section: Introductionmentioning

confidence: 99%

Treating refractory wounds with necrotic tissue, using wound gel and dietary modifications

Shannon Payseur,

Warren Lesser,

Kenneth Gossett

et al. 2023

Asian J Med Sci

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Background: A certified hyperbaric and wound care specialist in the South-west US evaluated three patients who presented with refractory wounds containing substantial necrotic tissue. Aims and Objectives: The primary aim/objective of this study was for the investigator to ascertain if the wound gel, in combination with dietary changes and standard hyperbaric oxygen treatment (HBOT) when placed on refractory wounds evidentiary with necrotic tissue, would result in favorable wound healing outcomes. This study’s secondary aim/objective was to determine if this treatment approach could result in avoiding costly and deleterious, life-changing amputations, and/or surgical reconstructions. Materials and Methods: The physician investigator conducted this qualitative method case study during her regular professional medical practice. She selected study subjects based on the exigency of patients’ needs. The three subjects selected met three inclusion criteria. The first inclusion criterion was that the patient had at least one serious refractory wound, which wound did not respond to any previous treatment regimens at any treatment center. The second inclusion criterion was that significant necrotic tissue was evidentiary in the wound(s). The third inclusion criterion was that each patient was facing traumatic surgical intervention – either amputation or excision with reconstruction. The investigator measured wound diameters and tracked the time to wound closure and wound healing. In addition, the investigator noted patient comments during the wound healing. Results: In two cases, patients were scheduled for umbilical reconstruction; in the third, the patient was scheduled for a frontal foot amputation. In 10 weeks, the three patients experienced complete wound healing or substantial wound resolution. Case #2 patient initially only received HBOT at a different wound center and was emergently admitted to the hospital after 2 weeks of HBOT (no dietary alteration or specialized wound gel application). The patient underwent wide excisional debridement with general surgery but received the trifurcated treatment regimen after discharge, resulting in wound healing within 10 weeks. Conclusion: These results warrant further study with more subjects to determine the replicability of findings. If the results are generalizable to this population of patients suffering from advanced refractory wounds and facing limb amputations, the health and quality-of-life benefits for these patients and the prospective cost savings on the U.S. health system could be incalculable.

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