Safety and sterilization of mosquito net mesh for humanitarian inguinal hernioplasty.

BACKGROUND: Inguinal hernia repair is one of the most commonly performed operations in Africa. Prosthetic repair with commercially available mesh is generally considered too expensive in low-income countries. Elective groin hernia surgery with mosquito net mesh has recently been described. However, can mesh sterility in resource-poor countries be guaranteed to ensure both effectiveness and safety?

METHODS: Copolymer and polyester mosquito net mesh were steam-sterilized at varying temperatures. PubMed and EMBASE were searched using key words, MeSH, and subject headings (mosquito net mesh, mesh sterilization, inguinal hernia repair).

RESULTS: Copolymer mosquito net mesh manufactured in India can be safely sterilized at lower (less "strict") temperatures (121°C) than those usually demanded by advanced health care systems (134°C). The literature search revealed a number of case series but all with limited follow-up. Available data, however, support the use of this type mosquito net mesh in the elective repair of hernias.

CONCLUSIONS: Hernia repair with mosquito net mesh is a plausible, safe, cost-effective alternative in low-income countries. Sterilization in steam autoclaves that have accurate temperature control is required.