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      Anthropometric Determinations of Umbilical Position in Iraqi Adults

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          Abstract

          Introduction  Umbilicus is an important surface landmark on the anterior abdominal wall in addition to its aesthetic and psychological effect.

          Objectives  The objective of the study is to determine the position of umbilicus in Iraqi adults to provide a guide for the neoumbilicus in abdominoplasty.

          Subjects and Methods  This is an observational study performed on 100 volunteers with no abdominal wall abnormality. Measurements included weight, height, body mass index (BMI), distance from xiphoid to umbilicus, distance from xiphoid process to pubic symphysis, distance from xiphoid process to both anterior superior iliac spine (ASIS), distance from pubic symphysis to umbilicus and from pubic symphysis to xiphisternum, distance of umbilicus to both ASIS, and distance of umbilicus to interspinous line and to inter-anterior hypochondrium line.

          Results  The study included 100 volunteers, with 50% male and 50% female whose age ranges between 18 to 60 years. The results were a follows: distance from xiphoid process to umbilicus and distance from xiphoid process to pubic symphysis were 18.03 ± 3.25 cm and 32.21 ± 4.64 cm, respectively; distances from xiphoid process to right ASIS and left ASIS were 25.95 ± 5.72 cm and 25.84 ± 6.02 cm, respectively; distance from pubic symphysis to umbilicus was 17.66 ± 3.12 cm; distance of umbilicus to interspinous line was 9.25 ± 1.84 cm. The distance from umbilicus to inter anterior hypochondrium line was 9.905 ± 2.19 cm.

          Conclusion  These measurements can determine the neoumbilicus position, reduce practical mistakes, and improve postsurgical outcomes.

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          Most cited references19

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          Anatomy and embryology of umbilicus in newborns: a review and clinical correlations.

          Umbilicus is considered a mirror of the abdomen in newborns. Despite its importance, the umbilicus has been stated in literature and textbooks as discrete subjects with many body systems, such as the urinary, digestive, and cardiovascular ones. This article aimed to address the basic knowledge of the umbilicus in relation to clinical disorders under one integrated topic to aid physicians and surgeons in assessing newborns and infants. The umbilicus appears as early as the fourth week of fetal life when the folding of the embryonic plate occurs. The umbilicus appears initially as a primitive umbilical ring on the ventral aspect of the body. The primitive umbilicus contains the connecting stalk, umbilical vessels, vitelline duct and vessels, allantois, and loop of the intestine. Changes occur to form the definitive cord, which contains three umbilical vessels, namely, "one vein and two arteries," embedded in Wharton's jelly. After birth, the umbilical vessels inside the body obliterate and gradually form ligaments. Congenital disorders at the umbilicus include herniation, bleeding, and discharge of mucous, urine, or feces. Some of these disorders necessitate emergent surgical interference, whereas others may be managed conservatively. The umbilicus has many embryological remnants. Thus, the umbilicus is prone to various clinical disorders. Detecting these disorders as early as possible is essential to prevent or minimize possible complications.
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            Creating the Perfect Umbilicus: A Systematic Review of Recent Literature.

            The aim of this study was to perform an updated systematic review of the literature over the last 10 years, analyzing and comparing the many published techniques with the hope of providing plastic surgeons with a new standard in creating the perfect umbilicus in the setting of both abdominoplasty and abdominally based free-flap breast reconstruction.
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              Anatomical localization of the umbilicus: an Indian study.

              The umbilicus is essential to the aesthetic appearance of the abdomen. However, very little has been written about the exact location of the aesthetically pleasing umbilicus as far as the Indian cosmopolitan population is concerned. Although a variety of reconstructive methods are available, no real standards define the location of the umbilicus. In this study, 75 cosmopolitan female volunteers were evaluated in supine position, and the distance of the umbilicus (from central stalk) to fixed bony points over the anterior abdominal wall was measured. These linear measurements were subjected to standard statistical methods. In this study, the authors observed that the umbilicus is situated around the midline plane such that the ratio of the distance between the xiphisternum and the umbilicus and the distance between the pubic symphysis and the umbilicus is 1.6:1; also, the ratio of the distance between the umbilicus and anterior superior iliac spine and the inter-anterior superior iliac spine is approximately 0.6:1. During umbilicoplasty, when each anterior superior iliac spine is taken as a center, and arcs are drawn with a radius 0.6 times that of the inter-anterior superior iliac spine distance, the point of intersection of these arcs is the approximate location of the umbilicus around the midline plane, which should match the ratio of 1.6:1 (i.e., the ratio of the distance from the umbilicus to the xiphisternum and the distance from umbilicus to the pubic symphysis). An effort is made to find and establish the body proportions and symmetry and to determine the critical ratios so as to help the reconstructive surgeon to plan an aesthetically pleasing umbilicus.
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                Author and article information

                Journal
                Indian J Plast Surg
                Indian J Plast Surg
                10.1055/s-00042863
                Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India
                Thieme Medical and Scientific Publishers Pvt. Ltd. (A-12, 2nd Floor, Sector 2, Noida-201301 UP, India )
                0970-0358
                1998-376X
                December 2020
                26 December 2020
                : 53
                : 3
                : 394-398
                Affiliations
                [1 ]Department of Surgery, College of Medicine, C.A.B.S. Basrah Teaching Hospital, University of Basrah, Basrah, Iraq
                [2 ]Department of Human Anatomy and Histology, College of Medicine, University of Basraha, Basrah, Iraq
                Author notes
                Address for correspondence Mazin Abdulsattar Abdulla Department of Surgery, College of Medicine, C.A.B.S. Basrah Teaching Hospital, University of Basrah Basrah, Ashar post, PO box 1035. Zip code, 61004Iraq mazin.abdulla@ 123456uobasrah.edu.iq
                Author information
                http://orcid.org/0000-0001-6909-1818
                Article
                IJPS2080755
                10.1055/s-0040-1721869
                7775206
                33402770
                1a1da6f0-cbb0-4e34-b42f-41a2820728aa
                Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

                History
                Categories
                Original Article

                Surgery
                umbilicus,abdominoplasty,measurements
                Surgery
                umbilicus, abdominoplasty, measurements

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