title: Feasibility and effectiveness of primary umbilical hernia repair with biologic graft: preliminary study.
abstract: BACKGROUND
  In this prospective non-randomized observational cohort study we evaluated: the feasibility and effectiveness of primary umbilical hernia repair with open tension-free and sutureless technique using a porcine small intestinal submucosa (Surgisis) prosthesis, the quality of the treatment in terms of reduction of postoperative discomfort and the complications at early and long-term follow-up.
  
  
  METHODS
  Thirty-six consecutive patients, mean age 45.25 +/- 12.19 years, affected by primary umbilical uncomplicated hernia with a defect size < or = 3 cm, were treated in a day-surgery setting. A tailored flat Surgisis graft was used to ensure an overlap of at least 2 cm; in all patients the mesh was fixed by fibrin glue. Collected data included: visual analogic scale (VAS) pain scores at 24 hours, 72 hours, and 7, 15, and 30 days and number of analgesic medications after operation, complications rate, the quality of life measured by Short Form 36 health survey questionnaire (SF-36) before the operation and at long term follow-up.
  
  
  RESULTS
  The mean follow-up time was 5.6 +/- 1.4 years. Postoperative pain was low: the mean visual analogic scale (VAS) scores were 2.8 at 24 h, 1.8 at 72 h, and 0.9, 0.3, and 0.04 at 7, 15, and 30 days, respectively. 77.8% of the patients (28/36) did not use any analgesic drugs. Seroma was reported in 13.8% of the patients (5/36); there were no hematomas, infection, chronic pain and no major complications or mortality (< or = 30 days). Recurrence rate was 2.8% (1/36). Patient satisfaction showed a significant improvement in all SF-36 domain scores (P < 0.001).
  
  
  CONCLUSIONS
  The biologic mesh seems to be a safe and reliable device for repairing primary umbilical hernia with high patient comfort, even if not yet an alternative to synthetic mesh.
authors: D P
authors: DP
authors: Greco
authors: L
authors: L
authors: Fei
authors: L
authors: L
authors: Guerriero
authors: P
authors: P
authors: Pradella
authors: M
authors: M
authors: Mazzola
authors: C
authors: C
authors: Magistro
authors: F
authors: F
authors: Moccia
authors: B
authors: B
authors: Pascotto
authors: T
authors: T
authors: Marra
authors: G
authors: G
authors: Rossetti
mesh_terms: D000328:Adult; D000368:Aged; D003094:Collagen / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D015718:Fibrin Tissue Adhesive; D005500:Follow-Up Studies; D006554:Hernia, Umbilical / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D055502:Secondary Prevention; D013526:Surgical Mesh; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; C588278:surgisis; D003094:Collagen