Prospective randomized controlled study using polyethylene mesh for inguinal hernia meshplasty as a safe and cost-effective alternative to polypropylene mesh

Abstract

Most patients who come to a general hospital in a developing country are poor. The most important prohibiting factor for use of polypropylene mesh in hernia repair is its exorbitant cost. Hence, research workers have been on the lookout for an equally effective but economically affordable mesh. Worldwide, surgical repair of inguinal hernia is the most common general surgery procedure performed at the present. Lifetime risk of groin hernia is 15% in males and 5% in females. Most of the patients who visit a general hospital are from either lower middle class or poor socioeconomic strata. The most important prohibiting factor for use of polypropylene mesh in hernia repair for the common man is its exorbitant cost. The aim of this study is to document the feasibility, safety and cost-effectiveness of the use of polyethylene mesh. A single blind, prospective, randomized controlled study, comparing 35 patients of two groups was conducted in a tertiary teaching hospital over a period of 5 years. The patients in both groups underwent inguinal hernioplasty, and were administered similar antibiotics and analgesics. The postoperative course with regard to pain, seroma formation, infection, hospital stay, recurrence and scar quality was evaluated and compared. Statistical analysis was performed with Chi square test. The properties of both meshes were the same with respect to ease of handling, pain score, seroma formation, infection rate, resumption of daily activities, scar quality and mesh rejection. Recurrence rate was zero for both groups. Polyethylene mesh was 2,808 times cheaper than the commercially available polypropylene mesh. This study proved the safety, simplicity, efficacy and cost-effectiveness of polyethylene mesh for inguinal hernia meshplasty, insuring economical, accessible health care for the financially weak section of the population.

Utilidad de la malla de polietileno de baja densidad, en la plastia inguinal sin tensión

“…Nuestros pacientes presentaron dolor leve en la mitad de los casos, resultados similares a los reportados por Gundre y col. (21). No se observaron infecciones, dehiscencia de herida quirúrgica, rechazos ni recurrencias en ninguno de los grupos, al igual que lo encontrado por Freudenberg y col. (13), donde se reportó 0% de rechazos e infecciones a diferencia de otros autores que informaron infección grave y profunda del sitio quirúrgico e infecciones superficiales en el 4,7% de los casos (5,15).…”

Single-Institution Financial Analysis of Biologic Versus Synthetic Mesh Hernia Repair

“…6 In the setting of socioeconomically disadvantaged patients, specific cost analyses have been published in respect to inguinal hernia repair mesh material and low cost associated with polyethylene mesh. 7 A growing body of hernia literature now permits a greater financial analysis of hernia, which would be important to evaluate the modalities available to manage this common entity.…”

Gels without Vapor Pressure: Soft, Nonaqueous, and Solvent‐Free Supramolecular Biomaterials for Prospective Parenteral Drug Delivery Applications

“…This phase mismatch does not disqualify such materials from long‐term use in vivo. There are several examples of hydrophobic, biologically inert materials that are well‐tolerated in vivo for years . Rather than matching bulk phase hydrophilicity, which is a common goal of hydrogel development, the oleogel materials capture the value of soft materials and are more suitable for delivery of hydrophobic drugs.…”