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 children with GS, it was always possible to preserve the UCA, even in those 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 surgery. We conclude that preservation of the UCA should be an integral part of surgical technique for all infants with GS. Reconstruction by 'umbilical cord capping' alone achieves an unscarred abdominal wall with an umbilicus of normal shape and position.