title: Safety and sterilization of mosquito net mesh for humanitarian inguinal hernioplasty.
abstract: 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.
authors.affiliation: Department of Surgery, Royal Gwent Hospital, Newport, Wales, NP20 2 UB, UK. brian.stephenson@wales.nhs.uk
authors.forename: Brian M
authors.initials: BM
authors.lastname: Stephenson
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Kingsnorth
mesh_terms: D000328:Adult; D000533:Altruism; D001512:Bedding and Linens; D015331:Cohort Studies; D007560:Cote d'Ivoire; D003906:Developing Countries; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057147:Mosquito Nets; D011203:Poverty; D018570:Risk Assessment; D017751:Safety Management; D013242:Sterilization / Q000379:methods*; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000517:prevention & control; D016896:Treatment Outcome