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

Löfgren, Jenny; Nordin, Pär; Ibingira, Charles; Matovu, Alphonsus; Galiwango, Edward; Wladis, Andreas

doi:10.1056/nejmoa1505126

Cited by 63 publications

(66 citation statements)

References 27 publications

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“…And where there are few instances that have established empirical evidence of equivalent outcomes for affordable healthcare interventions, the relevance of frugal models or technologies are usually espoused as relevant to mainly low-resource settings. See, for instance, two recent articles in the Lancet , one for affordable vaccines,30 and the other for the affordable assessment of haemoglobin,31 as well as one article in New England Journal of Medicine on mosquito mesh for hernia surgery 32. The NEJM paper concludes: ‘In summary, this study showed that a low-cost mesh can be used in hernia repair with excellent clinical outcomes that do not differ significantly from those achieved with commercial mesh.…”

Section: Discussionmentioning

confidence: 85%

The search for the holy grail: frugal innovation in healthcare from low-income or middle-income countries for reverse innovation to developed countries

et al. 2017

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The healthcare sector stands to benefit most from frugal innovation, the idea that more can be done for less for many more people, globally. As a first step for health systems to leverage new approaches to offset escalating health expenditures and to improve health outcomes, the most relevant frugal innovations have to be found. The Institute of Global Health Innovation was commissioned by the US-based Commonwealth Fund to identify frugal innovations from around the world that could, if transferred to the USA, offer approaches for expanding access to care and dramatically lower costs. Our global scan was motivated by the need to extend the list of frugal innovations in healthcare beyond the impressive but oft-repeated examples such as GE’s MAC 400, a US$800 portable ECG machine, Narayana’s US$1500 cardiac surgery and Aravind’s US$30 cataract surgery. Our search involved (1) scanning innovation databases, (2) refining frameworks to identify frugal innovations and evaluate their reverse potential and (3) developing in-depth case studies. From 520 possible innovations, we shortlisted 16 frugal innovations that we considered as frugal and with potential for reverse diffusion into high-income country health systems. Our global search was narrowed down to three care delivery models for case analysis: The Brazilian Family Health Strategy around community health workers; Singapore-based GeriCare@North use of telemedicine and Brazil’s Saude Crianca community involvement and citizenship programme. We share core features of the three frugal innovations and outline lessons for practitioners, scholars and policymakers seeking to lower healthcare costs while increasing access and quality.

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Section: Discussionmentioning

confidence: 85%

The search for the holy grail: frugal innovation in healthcare from low-income or middle-income countries for reverse innovation to developed countries

et al. 2017

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“…Patients were followed for 1 year after surgery. The primary outcomes of the study were hernia recurrence and postoperative infections. The secondary outcomes were chronic pain assessed by the Inguinal Pain Questionnaire (IPQ; a 7‐point scale where 1 represents no pain and 7 severe pain), quality of life assessed using the EQ‐5D™ questionnaire (EuroQol Group, Rotterdam, The Netherlands), and patient satisfaction.…”

Section: Methodsmentioning

confidence: 99%

“…Mosquito mesh is similar in structure and comes at a fraction of the cost of commercial meshes. It has been shown to be a safe and effective alternative to commercially available mesh. The aim of the present study was to compare the cost‐effectiveness of groin hernia surgery using a low‐cost mesh and a commercial mesh.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of groin hernia repair from a randomized clinical trial comparing commercial versus low-cost mesh in a low-income country

Löfgren

Matovu

Wladis

et al. 2017

British Journal of Surgery

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“…Randomised clinical studies have shown that this concept might be valid [7]. Another means to decrease the cost of these meshes is also to sterilize polypropylene pieces that are cut from large unused medical meshes.…”

Section: To the Editors Of The Pan African Medical Journalmentioning

confidence: 99%

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

2017

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

Cited by 63 publications

References 27 publications

The search for the holy grail: frugal innovation in healthcare from low-income or middle-income countries for reverse innovation to developed countries

The search for the holy grail: frugal innovation in healthcare from low-income or middle-income countries for reverse innovation to developed countries

Cost-effectiveness of groin hernia repair from a randomized clinical trial comparing commercial versus low-cost mesh in a low-income country

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

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