A New Method of Umbilical Transposition : The Combination of Sandglass Style Incision and Horizontal H-shaped Incision with Elevating Rectus Abdominis Myocutaneous Flap

Abstract

Rectus abdominis myocutaneous flaps are one of the most popular flaps in plastic and reconstructive surgery. To close the donor site of TRAM flaps, transposition of the umbilicus to the cranial flap is required. In general, the umbilicus is detached from the TRAM to make a round shape, pulled through to the cranial flap, and finally sutured with an I-shape incision. However, this method often creates a narrow umbilicus due to scarring. We devised a new method in which the umbilicus is detached from the TRAM with a sandglass style incision, and is then pulled through to the cranial flap and sutured with a horizontal H-sharped incision. This method decreased scarring around the umbilicus, and made a natural umbilicus.