Do Hernia Operations in African International Cooperation Programmes Provide Good Quality?

• Published in: World journal of surgery 2012-12, Vol.36 (12), p.2795-2801
• Main Authors: Gil, J., Rodríguez, J. M., Hernández, Q., Gil, E., Balsalobre, M. D., González, M., Torregrosa, N., Verdú, T., Alcaráz, M., Parrilla, P.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adolescent; Adult; African Group; Aged; Aged, 80 and over; Bilateral Inguinal Hernia; Cameroon; Cardiac Surgery; Charities; Female; Follow-Up Studies; General Surgery; Hernia Repair; Hernia, Inguinal - surgery; Herniorrhaphy - instrumentation; Herniorrhaphy - methods; Herniorrhaphy - standards; Herniorrhaphy - statistics & numerical data; Humans; Inguinal Hernia; International Cooperation; Length of Stay - statistics & numerical data; Male; Mali; Medicine; Medicine & Public Health; Middle Aged; Operative Time; Postoperative Complications - epidemiology; Preoperative Care - methods; Preoperative Care - standards; Quality Indicators, Health Care - statistics & numerical data; Spain; Spanish Group; Surgery; Surgical Mesh - utilization; Thoracic Surgery; Treatment Outcome; Vascular Surgery; Young Adult
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-012-1768-9

Background Hernia is especially prevalent in developing countries where the population is obliged to undertake strenuous work in order to survive, and International Cooperation Programmes are helping to solve this problem. However, the quality of surgical interventions is unknown. The objective of the present study was to evaluate the quality of hernia repair processes carried out by the Surgical Solidarity Charity in Central African States. Materials and methods A total of 524 cases of inguinal hernia repair carried out in Cameroon and Mali during 2005 to 2009 were compared with 386 cases treated in a Multicentre Spanish Study (2003). General data (clinical, demographic, etc.), type of surgery, complications, and effectiveness and efficiency indicators were collected. Results Preoperative studies in the Spanish group were greater in number than in the African group. The use of local anesthesia was similar. Antibiotic prophylaxis was higher in the African group (100 % to 75.4 %). The use of mesh was similar. The incidence of hematomas was higher in the Spanish group (11.61 % to 4.61 %), but the incidence of infection of the wound and of hernia recurrence was similar, although follow-up was only carried out in 20.97 % in the African group (70 % in the Spanish group). Hospital stay of more than 24 h was higher in the Spanish group. Conclusions The standard quality of surgery for the treatment of hernia in developing countries with few instrumental means, and in sub-optimal surgical conditions is similar to that provided in Spain.