RESUMEN
The umbilicus is an important aesthetic feature of the abdomen and thus calls for an optimized reinsertation technique. Localization and characteristics of the umbilicus were assessed in 137 adults. In addition, age, height, weight, pregnancy, and gender were recorded. Each participant reviewed his own photographs while the authors reviewed all of them. The categorization included a rating and an evaluation of the silhouette. A vertical-configured umbilicus was the most frequently observed. Nevertheless, the score for oval shape was superior. Following a pregnancy, the navel became shorter and wider. Furthermore, the distances measured between the fixed bony points were larger in males and as BMI increased. The height of a person had no impact on the position or height of the umbilicus. An oval-shaped umbilicus that is positioned at 2/3 of the distance from the pubis to the xiphisternum may lead to the most aesthetic results. Thus, the goal in umbilicoplasty is to obtain this configuration.
Asunto(s)
Cirugía Plástica/métodos , Técnicas de Sutura , Ombligo/cirugía , Pared Abdominal/cirugía , Adulto , Factores de Edad , Anciano , Antropometría , Índice de Masa Corporal , Distribución de Chi-Cuadrado , Estudios de Cohortes , Estética , Femenino , Estudios de Seguimiento , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Medición de Riesgo , Factores Sexuales , Estadísticas no Paramétricas , Resultado del Tratamiento , Cicatrización de Heridas/fisiología , Adulto JovenRESUMEN
Controversy surrounds the question whether free flaps remain dependent for blood supply on their vascular pedicle or if there is an autonomization by neovascularization from the surrounding wound bed. This becomes important when flap shaping or repositioning are performed. Our study involved 23 patients who received a deep inferior epigastric perforator (DIEP) flap for breast reconstruction. IC-View laser video angiography (Pulsion Medical Systems AG, Munich, Germany) was executed immediately and 18 months postoperatively. Two zones (close and distant to the pedicle) and the contralateral breast were compared quantitatively. Via duplex ultrasound, late perfusion changes were measured to analyze flow volume, velocity, and diameter of the internal thoracic artery and the DIEP-flap pedicle. In the long term, early postoperative flap hyperperfusion changed to flap hypoperfusion. No enhanced flow from the flap surrounding into the flap borders was measured. These results might indicate a long-term increase in total peripheral vascular resistance of the transplanted tissue. Postoperative perfusion after 18 months remains dependent on the anastomosed vascular pedicle.