Low-cost mesh for inguinal hernia repair in resource-limited settings

J. Yang, D. Papandria, Daniel Rhee, Henry Baker Perry, F. Abdullah

Research output: Contribution to journalArticle

Abstract

Introduction: Hernia repair is one of the most frequently performed surgical procedures worldwide, yet more than half of hernias may be untreated in African countries that lack adequate and affordable surgical care. Although this disease burden can be effectively reduced by surgical repair, public health efforts to promote repair have been sparse because of the presumed high cost of surgery. Objective: To review the epidemiology and treatment of hernias in African countries and to assess the efficacy and safety of using low-cost mesh for repair in resource-limited settings. Methods: An extensive literature search was performed using PubMed and the Cochrane Library to locate pertinent background information and studies that used low-cost alternatives to commercial mesh. Results: Most hernia repairs in Africa are performed as high-risk emergency procedures. When treatment is provided, fewer than 5% are repaired using implanted mesh because of its high cost, despite the demonstrated improvement in clinical outcomes with tension-free repair. A total of four studies using low-cost mesh were reviewed. Three of the studies compared postoperative outcomes for repairs using sterile mosquito nets with those using commercial surgical mesh. The fourth study randomized patients to receive either an indigenous bilayer device or the Prolene Hernia System. No significant differences in recurrence or in incidence of wound complications between repairs using low-cost and commercial mesh were observed. The price of low-cost mesh was generally less than 1/1,000 the price of commercial mesh. Conclusions: There were no significant differences in outcomes between repairs using low-cost and commercial mesh. While the size of the study populations and the limited time for follow-up preclude conclusive measures of effectiveness, recurrence, and long-term complications, these studies demonstrate that providing an improved standard of surgical care need not be prohibitively expensive.

Original languageEnglish (US)
Pages (from-to)485-489
Number of pages5
JournalHernia
Volume15
Issue number5
DOIs
StatePublished - Oct 2011

Fingerprint

Inguinal Hernia
Herniorrhaphy
Costs and Cost Analysis
Hernia
Surgical Mesh
Mosquito Nets
Recurrence
Polypropylenes
Standard of Care
Population Density
PubMed
Libraries
Epidemiology
Emergencies
Public Health
Safety
Equipment and Supplies
Incidence
Wounds and Injuries
Therapeutics

Keywords

  • Africa
  • Herniorraphy
  • Inguinal hernia
  • Low-cost mesh
  • Low-income country
  • Surgical mesh
  • Tension-free repair

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Low-cost mesh for inguinal hernia repair in resource-limited settings. / Yang, J.; Papandria, D.; Rhee, Daniel; Perry, Henry Baker; Abdullah, F.

In: Hernia, Vol. 15, No. 5, 10.2011, p. 485-489.

Research output: Contribution to journalArticle

Yang, J. ; Papandria, D. ; Rhee, Daniel ; Perry, Henry Baker ; Abdullah, F. / Low-cost mesh for inguinal hernia repair in resource-limited settings. In: Hernia. 2011 ; Vol. 15, No. 5. pp. 485-489.
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