The Normal Position of Umbilicus in the Newborn: An Aid to Improve Cosmetic Result in Exomphalos Major

Abstract

Background: Position of umbilicus is an important esthetic landmark and its absence or deformity may be associated with poor self-image. In abdominoplasty, the creation of a normal-looking, well shaped and sufficiently deep umbilicus on a normal position seems essential. The aim of this study was to determine the normal position of umbilicus and hence to improve the cosmetic result of exomphalos major repair. Methods: In a cross-sectional study the position of umbilicus was determined in a random sample of 200 healthy and normal neonates (107 boys and 93 girls) who were born in Isfahan University hospitals from Oct. 2002 till Mar. 2003, with respect to the xiphisternum and pubis. Results: The normal umbilical position was 59.3 ± 5.2 percent of the way from the inferior border of xiphisternum to the superior border of the pubis in the midline and it was independent of gender and neonatal Conclusions: Recent years have witnessed major improvements in the survival of newborns with exomphalocele. The primary repair of the abdominal wall with umbilicoplasty is generally considered the treatment of choice, and the cosmetic appearance of the navel becomes increasingly important as children grow older. In repair of exomphalos major, the most esthetically pleasing result is obtained if the umbilicus is placed 59.3% of the way from the xiphisternum to the pubis.
Keywords: Umbilicus, Exomphalos, Neonate, Umbilicoplasty, Isfahan