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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
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
Hernia, Volume 18, No. 4, Year 2014
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Description
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. © 2014 Springer-Verlag.
Authors & Co-Authors
Wang, Y. T.
United States, Baltimore
Johns Hopkins School of Medicine
Mehes, Mira M.
United States, Baltimore
Johns Hopkins School of Medicine
Naseem, H. R.
United States, Little Rock
University of Arkansas for Medical Sciences
Ibrahim, Mohamed Hamdy
Ghana
Ahmadiyya Hospital Compound
Butt, M. A.
Ghana
Ahmadiyya Muslim Hospital
Ahmed, Na'Eem
Ghana
Ahmadiyya Muslim Hospital
Wahab Bin Adam, M. A.
Ghana
Ahmadiyya Muslim Mission
Issah, A. W.
Ghana, Accra
Humanity First Ghana
Mohammed, Idris
Ghana, Accra
Majlis Nusrat Jehan Board
Goldstein, Seth D.
United States, Baltimore
Johns Hopkins School of Medicine
Cartwright, K.
United States, Madera
Children's Hospital Central California
Abdullah, Fizan
United States, Baltimore
Johns Hopkins School of Medicine
Statistics
Citations: 15
Authors: 12
Affiliations: 8
Identifiers
Doi:
10.1007/s10029-014-1255-3
ISSN:
12654906
e-ISSN:
12489204
Research Areas
Health System And Policy
Study Design
Randomised Control Trial
Cohort Study