The use of mesh for inguinal hernia repair in northern Ghana.
J Surg Res
; 230: 137-142, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-30100030
ABSTRACT
BACKGROUND:
Despite the recognition that inguinal hernia (IH) repair is cost-effective, repair rates in low- and middle-income countries remain low. Estimated use of mesh in low- and middle-income countries also remains low despite publications about low-cost, noncommercial mesh. The purpose of our study was to assess the current state of IH repair in the northern and transitional zone of Ghana. MATERIALS ANDMETHODS:
A retrospective review of surgical case logs of IH repairs from 2013 to 2017 in 41 hospitals was performed. Multivariate logistic regression was used to determine predictors of mesh use.RESULTS:
Eight thousand eighty male patients underwent IH repair. The range of IH repair in each region was 96 to 295 (overall 123) per 100,000 population. Most cases were performed at district hospitals (84%) and repaired nonurgently (93%) by nonsurgeon physicians (66%). Suture repair was most common (85%) although mesh was used in 15%. The strongest predictor of mesh use was when a surgeon performed surgery (odds ratio [OR] 3.13, P <0.001), followed by surgery being performed in a teaching hospital (OR 2.31, P <0.001). Repair at a regional hospital was a negative predictor of mesh use (OR 0.08, P <0.001) as was the use of general anesthesia (OR 0.40, P = 0.001).CONCLUSIONS:
Most IH repairs are performed in district hospitals, by nonsurgeon physicians, and without mesh. Rates of repair and the use of mesh are higher than previous estimates in Ghana and Sub-Saharan Africa but not as high as high-income countries.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Próteses e Implantes
/
Telas Cirúrgicas
/
Herniorrafia
/
Hérnia Inguinal
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
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Male
/
Middle aged
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article