Use of resterilized polypropylene mesh in inguinal hernia repair: a prospective, randomized study.
BACKGROUND
Inguinal hernia repair consumes considerable health-care resources worldwide. Open mesh repairs are commonly used and the feasibility of using a resterilized mesh, which is a general practice in certain countries, has not been evaluated.


METHODS
In this randomized prospective study, original and resterilized meshes were used in two groups of patients with unilateral inguinal hernia. Microbiologic changes, textile mechanical properties, overall complication rates, and cost-effectiveness of resterilized mesh were investigated. A time period of 3 years was determined for patient enrollment to this pilot feasibility study, with the goal of 100 patients in each group.


RESULTS
Ninety-one patients were enrolled in the original group and 93 in the resterilized mesh group. Median followup was 735 and 739 days and calculated interquartile ranges were 454 and 513 days, respectively. Average tensile strength of the original polypropylene mesh changed slightly with resterilization, as maximum load decreased from a mean of 66.6 to 58.2 N/cm. Overall complication rates were similar in the two groups. The 6.6% infection rate in the original mesh group was not statistically different from the 7.5% rate in the resterilized group (p = 0.80, relative risk = 0.88, 95% confidence interval, 0.31-2.51). There was only one recurrence in the original mesh group in the 21st month. Use of a resterilized mesh decreased the overall cost of operation by decreasing the cost of mesh from 15.9% to 8.3% of the total amount.


CONCLUSIONS
Use of a resterilized mesh for inguinal hernia repair is feasible without considerable changes in infection and recurrence rates.
Cingi
Asim
A
Department of General Surgery, Marmara University School of Medicine, Istanbul, Turkey.
Manukyan
Manuk N
MN
Güllüoğlu
Bahadir M
BM
Barlas
Afşar
A
Yeğen
Cumhur
C
Yalin
Rifat
R
Yilmaz
Nuray
N
Aktan
A Ozdemir
AO
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D017743:Equipment Reuse / Q000191:economics; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes; D011446:Prospective Studies; D013242:Sterilization; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000209:etiology; D013718:Tensile Strength; D014421:Turkey
D011126:Polypropylenes