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Hernia recurrence after primary repair of small umbilical hernia defects

Published:September 23, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.09.019

      Highlights

      • Primary sutured repair of umbilical hernia defects had a recurrence rate of 3.6% after 4.7 years.
      • Incisional umbilical hernias were 4.2 times more likely to recur compared to primary defects.
      • Suture choice, diabetes, BMI, tobacco use history, and wound complications did not predict hernia recurrence.

      Abstract

      Background

      An evidence-based approach to the repair of umbilical hernias (UH)<1 cm has yet to be defined.

      Methods

      A prospectively maintained, institutional hernia database was queried for patients undergoing primary suture repair of UH ≤ 1 cm. The primary outcome was recurrence and secondary outcomes were wound complications.

      Results

      Of 332 patients included (226-primary, 106-incisional), recurrence was identified in 4 (1.8%) primary versus 8 (7.5%) incisional-UH (p = 0.022), with follow-up of 4.7 ± 4.4 years. There were 10 (3.0%) wound complications: 4 (1.2%) superficial wound infections, 1 (0.3%) superficial wound dehiscence, and 5 (1.5%) seromas. On multivariable analysis of recurrence, incisional-UH had an odds ratio of 4.2 compared to primary. Suture choice, diabetes, BMI, tobacco-use history, and wound complications were not significant.

      Conclusions

      With long term follow-up, recurrence after primary suture repair of UH ≤ 1 cm occurred in 1.8% of primary and 7.5% of incisional UH. On multivariable analysis, incisional-UH increased recurrence odds by 4.2 times compared to primary.
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