Treatment of Fat Supraumbilical Hernia

Surgical Approach Based on Hernia Characteristics

• Prosthetic repair with a synthetic mesh is the recommended treatment for fat supraumbilical hernia due to significantly lower recurrence rates compared to tissue repair, without an increase in wound infection rates, as recommended by the World Journal of Emergency Surgery 1, 2, 3
• Mesh repair is strongly recommended for supraumbilical hernias in clean surgical fields (CDC wound class I) 4
• The advantages of mesh repair include lower long-term complication rates 1, significant reduction in recurrence rates (0% with mesh vs 19% without mesh in paraumbilical hernias) 2, and low rates of wound infection (comparable to suture repair) 2

Surgical Technique Options

• Laparoscopic approach may be considered for uncomplicated hernias with benefits including lower wound infection rates 5 and shorter hospital stay 6

Special Considerations

Complicated Hernias

• In cases of intestinal incarceration without strangulation, mesh repair remains recommended 2
• For strangulated hernias with intestinal compromise and no gross enteric spillage (CDC wound class II), emergent prosthetic repair with synthetic mesh is still recommended 4
• For strangulated hernias with bowel necrosis or gross enteric spillage (CDC wound class III/IV), primary repair is recommended for small defects (<3 cm) 7