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Hernia
Published in: Hernia 4/2014

01-08-2014 | Original Article

Assessing the impact of short-term surgical education on practice: a retrospective study of the introduction of mesh for inguinal hernia repair in sub-Saharan Africa

Authors: Y. T. Wang, M. M. Meheš, H.-R. Naseem, M. Ibrahim, M. A. Butt, N. Ahmed, M. A. Wahab Bin Adam, A.-W. Issah, I. Mohammed, S. D. Goldstein, K. Cartwright, F. Abdullah

Published in: Hernia | Issue 4/2014

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Abstract

Purpose

Inguinal hernia repair is the most common general surgery operation performed globally. However, the adoption of tension-free hernia repair with mesh has been limited in low-income settings, largely due to a lack of technical training and resources. The present study evaluates the impact of a 2-day training course instructing use of polypropylene mesh for inguinal hernia repair on the practice patterns of sub-Saharan African physicians.

Methods

A surgical training course on tension-free mesh repair of hernias was provided to 16 physicians working in rural Ghanaian and Liberian hospitals. Three physicians were requested to prospectively record all their inguinal hernia surgeries, performed with or without mesh, during the 14-month period following the training. Demographic variables, diagnoses, and complications were collected by an independent data collector for mesh and non-mesh procedures.

Results

Surgery with mesh increased significantly following intervention, from near negligible levels prior to the training to 8.1 % of all inguinal hernia repairs afterwards. Mesh repair accounted for 90.8 % of recurrent hernia repairs and 2.9 % of primary hernia repairs after training. Overall complication rates between mesh and non-mesh procedures were not significantly different (p = 0.20).

Conclusions

Three physicians who participated in an intensive education course were routinely using mesh for inguinal hernia repair 14 months after the training. This represents a significant change in practice pattern. Complication rates between patients who underwent inguinal hernia repairs with and without mesh were comparable. The present study provides evidence that short-term surgical training initiatives can have a substantial impact on local healthcare practice in resource-limited settings.
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Metadata
Title
Assessing the impact of short-term surgical education on practice: a retrospective study of the introduction of mesh for inguinal hernia repair in sub-Saharan Africa
Authors
Y. T. Wang
M. M. Meheš
H.-R. Naseem
M. Ibrahim
M. A. Butt
N. Ahmed
M. A. Wahab Bin Adam
A.-W. Issah
I. Mohammed
S. D. Goldstein
K. Cartwright
F. Abdullah
Publication date
01-08-2014
Publisher
Springer Paris
Published in
Hernia / Issue 4/2014
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-014-1255-3

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