Literature DB >> 26760085

A Randomized Trial of Low-Cost Mesh in Groin Hernia Repair.

Jenny Löfgren1, Pär Nordin, Charles Ibingira, Alphonsus Matovu, Edward Galiwango, Andreas Wladis.   

Abstract

BACKGROUND: The most effective method for repair of a groin hernia involves the use of a synthetic mesh, but this type of mesh is unaffordable for many patients in low- and middle-income countries. Sterilized mosquito meshes have been used as a lower-cost alternative but have not been rigorously studied.
METHODS: We performed a double-blind, randomized, controlled trial comparing low-cost mesh with commercial mesh (both lightweight) for the repair of a groin hernia in adult men in eastern Uganda who had primary, unilateral, reducible groin hernias. Surgery was performed by four qualified surgeons. The primary outcomes were hernia recurrence at 1 year and postoperative complications.
RESULTS: A total of 302 patients were included in the study. The follow-up rate was 97.3% after 2 weeks and 95.6% after 1 year. Hernia recurred in 1 patient (0.7%) assigned to the low-cost mesh and in no patients assigned to the commercial mesh (absolute risk difference, 0.7 percentage points; 95% confidence interval [CI], -1.2 to 2.6; P=1.0). Postoperative complications occurred in 44 patients (30.8%) assigned to the low-cost mesh and in 44 patients (29.7%) assigned to the commercial mesh (absolute risk difference, 1.0 percentage point; 95% CI, -9.5 to 11.6; P=1.0).
CONCLUSIONS: Rates of hernia recurrence and postoperative complications did not differ significantly between men undergoing hernia repair with low-cost mesh and those undergoing hernia repair with commercial mesh. (Funded by the Swedish Research Council and others; Current Controlled Trials number, ISRCTN20596933.).

Entities:  

Mesh:

Year:  2016        PMID: 26760085     DOI: 10.1056/NEJMoa1505126

Source DB:  PubMed          Journal:  N Engl J Med        ISSN: 0028-4793            Impact factor:   91.245


  21 in total

Review 1.  A systematic review and meta-analysis of the post-operative adverse effects associated with mosquito net mesh in comparison to commercial hernia mesh for inguinal hernia repair in low income countries.

Authors:  T Patterson; P Currie; S Patterson; P Patterson; C Meek; R McMaster
Journal:  Hernia       Date:  2017-04-13       Impact factor: 4.739

2.  An in vitro study on the biocompatibility of fibroblasts in sterile and non-sterile low-cost and commercial meshes.

Authors:  R Wiessner; A Gehring; T Kleber; N Ekwelle; R Lorenz; D-U Richter
Journal:  Hernia       Date:  2019-04-04       Impact factor: 4.739

3.  In-vitro examination of the biocompatibility of fibroblast cell lines on alloplastic meshes and sterilized polyester mosquito mesh.

Authors:  R Wiessner; T Kleber; N Ekwelle; K Ludwig; D-U Richter
Journal:  Hernia       Date:  2016-11-23       Impact factor: 4.739

4.  Low-cost innovation in healthcare: what you find depends on where you look.

Authors:  Matthew Harris; Yasser Bhatti; Matt Prime; Jacqueline Del Castillo; Greg Parston
Journal:  J R Soc Med       Date:  2017-11-08       Impact factor: 5.344

5.  Prostheses Used in Laparoscopic Inguinal Hernia Repair: Biocompatibility, Postoperative Complications and Quality of Life - Review of the Literature.

Authors:  Alexandra Florina Trandafir; Dorin Eugen Popa; Danut Vasile
Journal:  Maedica (Bucur)       Date:  2017-09

6.  Consensus on international guidelines for management of groin hernias.

Authors:  Nadine van Veenendaal; Maarten Simons; William Hope; Sathien Tumtavitikul; Jaap Bonjer
Journal:  Surg Endosc       Date:  2020-04-06       Impact factor: 4.584

7.  Inguinal hernia surgery in developing countries: should laparoscopic repairs be performed ?

Authors:  Berthier Nsadi; Olivier Detry; Willy Arung
Journal:  Pan Afr Med J       Date:  2017-05-02

8.  Improving surgical education in East Africa with a standardized hernia training program.

Authors:  R Lorenz; C Oppong; A Frunder; M Lechner; D M Sedgwick; A Tasi; R Wiessner
Journal:  Hernia       Date:  2020-03-10       Impact factor: 4.739

9.  Desarda's technique versus Lichtenstein technique for the treatment of primary inguinal hernia: a systematic review and meta-analysis of randomized controlled trials.

Authors:  S H Emile; H Elfeki
Journal:  Hernia       Date:  2017-09-09       Impact factor: 4.739

10.  International guidelines for groin hernia management.

Authors: 
Journal:  Hernia       Date:  2018-01-12       Impact factor: 4.739

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