{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:13:56Z","timestamp":1792793636099,"version":"4.5.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T00:00:00Z","timestamp":1740960000000},"content-version":"vor","delay-in-days":63,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical Resident Research"},{"name":"S\u00f6dert\u00e4lje Hospital","id":[{"id":"https:\/\/ror.org\/0376t7t08","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mesh repair is recommended for umbilical hernias larger than 1\u2005cm to reduce recurrence rates, yet current evidence remains limited for smaller umbilical hernias. Important questions concern optimal mesh positioning and wound complications\/surgical-site occurrences. The aim of this study was to report the preliminary results of a trial investigating surgical-site occurrences in suture versus mesh repair for umbilical hernias less than or equal to 2\u2005cm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomized, controlled, parallel-group, double-blind, multicentre trial across six Swedish surgical units is comparing 4 \u00d7 4\u2005cm macroporous lightweight onlay mesh repair with conventional suture repair for primary elective umbilical hernias less than or equal to 2\u2005cm. Intraoperative centralized web-based randomization ensured allocation concealment. The primary outcome of the trial is recurrence at 3 years, whereas secondary outcomes (the focus of this study) include surgical-site occurrences and pain intensity at 30 days post-surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From February 2020 to January 2024, 290 participants were randomly assigned to either suture or mesh repair. After exclusion and loss to follow-up, the remaining population for analysis was 144 participants for suture repair and 135 participants for mesh repair. Surgical-site occurrences (Clavien\u2013Dindo grade greater than or equal to I) affected 32 mesh repair participants (23.7%) compared with 26 suture repair participants (18.1%), without any significant increase in surgical-site occurrences for mesh repair (OR 1.39 (95% c.i. 0.78 to 2.51)). Clinically relevant surgical-site occurrences (Clavien\u2013Dindo grade greater than or equal to II) were less common in the mesh group (2 participants; 1.5%) compared with the suture group (4 participants; 2.8%). The median duration of surgery was 32\u2005min for suture repair and 45\u2005min for mesh repair (P &amp;lt; 0.001). Assessment of pain intensity revealed that 82.0% of suture repair participants and 73.0% of mesh repair participants reported no pain (P = 0.061).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This randomized clinical trial provides high-level evidence for mesh repair for umbilical hernias less than or equal to 2\u2005cm. With regard to early postoperative outcomes, such as surgical-site occurrences, onlay mesh repair can be considered comparable to suture repair and is safe to use for smaller umbilical hernias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration number<\/jats:title>\n                    <jats:p>NCT04231071 (http:\/\/www.clinicaltrials.gov).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrae173","type":"journal-article","created":{"date-parts":[[2024,12,28]],"date-time":"2024-12-28T07:23:06Z","timestamp":1735370586000},"source":"Crossref","is-referenced-by-count":6,"title":["Onlay mesh\n                    <i>versus<\/i>\n                    suture repair for smaller umbilical hernias in adults\u2014early results from SUMMER trial: randomized clinical trial"],"prefix":"10.1093","volume":"9","author":[{"given":"Mathias","family":"Bergstr\u00f6m","sequence":"first","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Surgery, S\u00f6dert\u00e4lje Hospital , S\u00f6dertalje ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Widhe","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Surgery, S\u00f6dert\u00e4lje Hospital , S\u00f6dertalje ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Gran\u00e5sen","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine, Ume\u00e5 University , Ume\u00e5 ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"L\u00f6f Granstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Clinical Sciences, Danderyds Hospital , Stockholm ,","place":["Sweden"]},{"name":"Department of Paediatric Surgery, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Ohlsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Danderyds Hospital , Stockholm ,","place":["Sweden"]},{"name":"Department of Surgery, Danderyds Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Schult","sequence":"additional","affiliation":[{"name":"Department of Surgery, H\u00f6gsbo Hospital HN, V\u00e4stra Fr\u00f6lunda , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3281-0959","authenticated-orcid":false,"given":"Ursula","family":"Dahlstrand","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Surgery, Enk\u00f6ping Hospital , Enk\u00f6ping ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"\u00d6sterberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Surgery, Mora Hospital , Mora ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Loogna","sequence":"additional","affiliation":[{"name":"Department of Surgery, Capio Surgery , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Bringman","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Surgery, S\u00f6dert\u00e4lje Hospital , S\u00f6dertalje ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2161-2888","authenticated-orcid":false,"given":"Maria","family":"Melkemichel","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Breast, Endocrine Tumours and Sarcoma, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,3]]},"container-title":["BJS Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/9\/1\/zrae173\/62212034\/zrae173.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/9\/1\/zrae173\/62212034\/zrae173.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T18:48:40Z","timestamp":1741114120000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjsopen\/article\/doi\/10.1093\/bjsopen\/zrae173\/8046902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,30]]},"references-count":0,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,12,30]]}},"URL":"https:\/\/doi.org\/10.1093\/bjsopen\/zrae173","relation":{},"ISSN":["2474-9842"],"issn-type":[{"value":"2474-9842","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,2]]},"published":{"date-parts":[[2024,12,30]]},"article-number":"zrae173"}}