Polyester mosquito net mesh for inguinal hernia repair: A feasible option in resource limited settings in Cameroon?

Abstract

Background: In developing countries, most inguinal hernia repairs are performed using Bassini or Shouldice techniques resulting in higher recurrence rates than with mesh placement. Our study aimed to evaluate the postoperative course and quality of life of patients undergoing inguinal hernia repair with a polyester mosquito net meshes during non-governmental organization health campaigns in Cameroon.

Methods: Patients were prospectively included from January to November 2013. Meshes were made from a polyester non-impregnated mosquito net purchased at a local market in Yaounde and sterilized on site.

Results: The total cost of a mesh was 0.21 USD. Among the 41 patients included in the study, 33 (80.5%) were men, 30 (72%) were farmers and the median age was 52 (21-80) years. The time between the onset of symptoms and surgery was 24 (3-240) months. Eleven (26.8%) patients had a previous history of hernia repair: 4 (9.7%) had been operated on the contralateral side and 7 (17.1%) had a recurrence. No intraoperative event related to the meshes was recorded. Three patients (7.2%) had a postoperative uninfected scrotal seroma, and 1 patient (2.4%) experienced a superficial skin infection that was treated using local care and oral antibiotics. No allergic rejection or deep infection was observed.

Conclusions: Meshes made from sterilized mosquito nets are safe and effective and provide a cost-effective alternative to commercially available meshes in countries with limited resources especially during non-governmental organization health campaigns.

Keywords: Developing countries; Indigents; Inguinal hernia; Mosquito mesh.