For a primary repair, the fascial edges are dissected out and reapproximated with interrupted braided polyester sutures (Ethibond, Johnson & Johnson) (Fig. 33.4). This can be done with interrupted or figure of 8 type sutures or utilizing a vest over pants technique. The base of the umbilicus is resecured to the underlying fascia with a single simple absorbable suture, and the overlying skin is then closed. In order to prevent seroma formation we place a cotton ball in the umbilicus, cover it with an occlusive dressing, and aspirate the air with a needle to create a pressure dressing (Fig. 33.5).