Novel technique and outcomes of umbilical reconstruction during cytoreductive surgery; a multi-centre study

Background The goal of cytoreductive surgery for peritoneal malignancy is to remove all macroscopic disease, which occasionally requires the excision of the umbilicus. While the absence of the umbilicus can be aesthetically undesirable for patients, umbilical reconstruction is rarely performed due to the perceived complexity and increased risk of wound infections [1]. This study aims to evaluate the outcomes, cosmetic results, and patient satisfaction of umbilical reconstruction during cytoreductive surgery. Methods Consecutive patients from a prospectively maintained database who underwent cytoreductive surgery with umbilical excision and reconstruction were evaluated. Our technique for umbilical reconstruction involved recreating the subcutaneous fat space and fashioning umbilical skin flaps that anchor to the anterior fascia. Outcomes assessed included postoperative infection rate, wound dehiscence, seroma formation, wound appearance, and patient satisfaction. Results Umbilical reconstruction was performed on 50 patients, with 12 (24%) experiencing wound-related complications. Of these, 8 patients (16%) had superficial wound infections, while 1 patient (2%) developed a deep wound infection. Three patients (6%) required local wound drainage, though none needed surgical revision. There were no reports of wound seromas, skin necrosis, wound widening, or umbilical stenosis. All patients reported satisfaction with the outcome of their reconstruction. Conclusion Our novel technique for umbilical reconstruction during cytoreductive surgery did not negatively impact wound healing outcomes. Recreating the umbilicus improved cosmetic results and patient satisfaction, enhancing body image for those undergoing major abdominal surgery. This approach should be considered for patients undergoing major laparotomies that necessitates umbilical excision.