A pledget for a suture is like a washer for a screw. A pledget distributes and increases the holding power of a suture. We use pledgeted sutures for repairing umbilical hernias. Pledgeted suturing was invented by cardiac surgeons to repair the aorta. The linea alba, which is the fascia around the umbilicus, is remarkably like the wall of the aorta, very thin and very strong but can tear like paper. The pledgets prevent the tearing in the aorta and in the linea alba. We have had tremendous success adopting this technique from cardiac surgery to repair umbilical hernias.
Umbilical hernia repair with pledgets