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World J Surg (2015) 39:127 DOI 10.1007/s00268-014-2788-4
INVITED COMMENTARY
Sutured Repair of Primary Small Umbilical and Epigastric Hernia: Concomitant Rectus Diastasis is a Signicant Risk-Factor for Recurrence
Danny Rosin
Published online: 18 September 2014 Socit Internationale de Chirurgie 2014
The use of mesh in hernia repair has become so ubiquitous that we tend to forget that pockets of resistance still exist, and primary suture repair is still prevalent. The two main justications for accepting a technique with higher recurrence rate are cost and the risk of infection. The latter was dismissed by numerous studies as small and acceptable in most instances except for high-risk situations like incarceration with bowel perforation. With proper antibiotic prophylaxis, there is no reason to avoid a mesh in elective, clean conditions. But cost is still an issue in many places around the globe, and...