The use of sterilised polyester mosquito net mesh for inguinal hernia repair in Ghana

The use of alloplastic mesh is now commonplace in hernia repair. However, in developing countries, cheaper alternatives to commercial mesh are required due to the high associated cost. Whilst nylon mosquito net mesh has been trialled previously, this study aimed to assess the use of polyester mosquito net mesh in tension-free inguinal hernia repair in Ghana.

All patients undergoing inguinal hernia repair during the 5-day 'Operation Hernia' mission in 2007 were eligible for the study. A piece of sterilised 10 x 15-cm 100% polyester mosquito net mesh, manufactured and donated by Scotmas Limited, was implanted for all tension-free hernia repairs. The surgeons' ease of handling and incidence of complications at 6 weeks and 6 months were assessed.

Ninety-five patients underwent inguinal hernia repair using a total of 106 polyester mosquito net meshes. The mean (range) age of patients was 44.3 (15-78) years. Seventy-two (76%) were repaired using local anaesthesia. At 6 weeks and 6 months, a total of seven (7%) patients suffered wound complications (five haematomas, two wound infections). Ease of practical handling improved after the first 2-5 cases. The cost of an individual 10 x 15-cm mesh was estimated at US$0.0072-0.014, and the cost of sterilisation and packaging was US$1.46 per mesh.

Polyester mosquito net mesh represents a cost-effective alternative to commercial meshes in developing countries, with a relatively low rate of early complications and similar short-term recurrence rates. The use of local anaesthesia may enhance this further.