title: Do hernia operations in african international cooperation programmes provide good quality?
abstract: 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.
  
  
  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.
authors.affiliation: General and Gastrointestinal Surgery Service, Virgen de la Arrixaca University Hospital, El Palmar, Murcia, Spain. ciranito@telefonica.net
authors.forename: J
authors.initials: J
authors.lastname: Gil
authors.forename: J M
authors.initials: JM
authors.lastname: Rodríguez
authors.forename: Q
authors.initials: Q
authors.lastname: Hernández
authors.forename: E
authors.initials: E
authors.lastname: Gil
authors.forename: M D
authors.initials: MD
authors.lastname: Balsalobre
authors.forename: M
authors.initials: M
authors.lastname: González
authors.forename: N
authors.initials: N
authors.lastname: Torregrosa
authors.forename: T
authors.initials: T
authors.lastname: Verdú
authors.forename: M
authors.initials: M
authors.lastname: Alcaráz
authors.forename: P
authors.initials: P
authors.lastname: Parrilla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002163:Cameroon; D002608:Charities; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007391:International Cooperation; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008302:Mali; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D013030:Spain; D013526:Surgical Mesh / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult