THE UMBILICUS IN GASTROSCHISIS - AESTHETIC CONSIDERATIONS

Preservation of the umbilical cord attachment (UCA) in gastroschisis ( GS) is still not routine practice. In a prospective series of 36 child ren with GS, it was always possible to preserve the UCA,, even in thos e undergoing a temporary silo and delayed closure. Reconstruction by ' umbilical cord capping' left no additional scar and achieved a normal abdominal wall. Mild cellulitis in 3 infants resolved on antibiotics, and an initial umbilical weakness in 7 did not require additional surg ery. We conclude that preservation of the UCA should be an integral pa rt of surgical technique for all infants with GS. Reconstruction by 'u mbilical cord capping' alone achieves an unscarred abdominal wall with an umbilicus of normal shape and position.