Primary umbilical endometriosis (PUE) is a rare condition seen in .5-1% of patients of endometriosis. This condition is a diagnostic dilemma. Once diagnosed, the definitive treatment is surgical excision. The umbilicus is an important aesthetic landmark, and in this condition, where the final goal is not only to cure, but to give the best result, umbilicoplasty plays an important role . Here we describe a patient with PUE, diagnosed and treated with wide excision and umbilicoplasty.

Perineal wound dehiscence is a significant debilitating factor in the postpartum phase. Although the management of 3rd and 4th degree perineal tear is well described, there is no clear data about management of 2nd degree tear and wound dehiscence. Most are managed by secondary suturing or left to heal by secondary intention. Despite this many patients develop wound dehiscence and have long term complications due to scarring. In this case report we present a patient with recurrent wound dehiscence which was initially managed by multiple attempts at suturing. We did a debridement and lotus petal perforator flap to reconstruct the defect. Early use of flap cover in perineal wound dehiscence can achieve all the goals of wound management with good long term results.