title: Reappraisal of adhesive strapping as treatment for infantile umbilical hernia.
abstract: BACKGROUND
  Most umbilical hernias spontaneously close by 3-5 years of age; therefore, surgical repair is considered only in children whose hernias have not closed by this point. At present, adhesive strapping is not the preferred treatment for umbilical hernias because of the lack of supporting evidence regarding its efficacy, and its association with skin complications. This aim of this study was to examine umbilical hernia closure on ultrasonography, and reassess the merits of adhesive strapping.
  
  
  METHODS
  Between January 2013 and December 2014, 89 infants underwent adhesive strapping for umbilical hernia. The strapping was changed once a week. The diameter of the hernia orifice was measured on ultrasonography every 2 weeks until closure. The closure speed (CS) of the hernia orifice was compared between the infants treated with adhesive strapping and those undergoing observation alone. The association between CS and birthweight, gestational age, diameter of the hernia orifice, and timing of treatment (before 12 weeks of age vs between 12 and 26 weeks of age) was also analyzed.
  
  
  RESULTS
  Closure was achieved after 2-13 weeks of strapping in 81 infants (91%), and the likelihood of closure was not affected by the diameter of the hernia orifice, gestational age, or the timing of treatment. The mean CS of the infants treated with adhesive strapping was significantly faster than that of the infants undergoing observation alone (2.59 vs 0.37 mm/week, P < 0.05). Adhesive strapping was discontinued in five of the 89 infants (5.6%) due to severe skin complications.
  
  
  CONCLUSIONS
  Adhesive strapping promoted early spontaneous umbilical hernia closure compared with observation alone, regardless of the diameter of the hernia orifice. Adhesive strapping is an effective alternative to surgery and observation.
authors.affiliation: Department of Pediatric Surgery, International University of Health and Welfare Hospital, Tochigi, Japan.
authors.forename: Satohiko
authors.initials: S
authors.lastname: Yanagisawa
authors.affiliation: Department of Pediatric Surgery, International University of Health and Welfare Hospital, Tochigi, Japan.
authors.forename: Mototoshi
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Pediatric Surgery, International University of Health and Welfare Hospital, Tochigi, Japan.|Department of Pediatric Surgery, Shikoku Central Hospital, Shikokuchuo, Japan.
authors.forename: Takehito
authors.initials: T
authors.lastname: Oshio
authors.affiliation: Department of Pediatric Surgery, International University of Health and Welfare Hospital, Tochigi, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Morikawa
mesh_terms: D001458:Bandages; D005260:Female; D005500:Follow-Up Studies; D006554:Hernia, Umbilical / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016896:Treatment Outcome; D014463:Ultrasonography; D057832:Watchful Waiting
keywords: adhesive surgical tape; complication; treatment; ultrasonography; umbilical hernia