Compliance to the South African ventral hernia guidelines: inaugural results from the HIG(SA) registry

Keywords: registry, low-middle income countries, ventral hernia, hernia guidelines

Abstract

Background: The Hernia Interest Group (HIG) of South Africa (SA), following the publication of their inguinal and ventral hernia guidelines (in 2015 and 2016 respectively), developed a hernia registry, the HIG(SA) hernia registry.

Methods: A retrospective analysis of the prospectively maintained HIG(SA) hernia registry from 1 February 2019 to 29 February 2020. Compliance to six recommendations made in the HIG(SA) ventral hernia guidelines were assessed in both the public and private healthcare systems.

Results: Three hundred and fifty-three ventral hernia repair cases were included in the study. Fifty-four per cent were private and 46% were public sector cases. Laparoscopic repair for patients with a BMI > 35 kg/m2 occurred in 38% of eligible cases and a minimum 5 cm of mesh overlap was achieved in 50% of cases. Overall, 80% of elective cases occurred in non-smokers; 97% of the intraperitoneal on-lay mesh (IPOM) repairs used composite mesh; 96% of ventral hernias with defects of larger than 2 cm and 95% of incisional hernias were repaired with mesh. Non-smokers undergoing repair numbered 72% in public and 85% in private practice, p = 0.01.

Conclusion: Ventral hernia repair practices in SA facilities overall had good compliance to four out of the sixHIG(SA) ventral hernia guidelines highlighted for the purposes of this study. The two guidelines that had poor compliance overall were ‘laparoscopic repair for patients with a BMI of > 35 kg/m2’ and ‘ensuring a mesh overlap of 5 cm’. The public sector had higher rates of current smokers undergoing elective ventral hernia repair.

Author Biographies

J Gouws, University of Cape Town

Division of General Surgery, Groote Schuur Hospital, University of Cape Town, South Africa

D Nel, University of Cape Town

Division of General Surgery, Groote Schuur Hospital, University of Cape Town, South Africa

H C Bougard, University of Cape Town

Division of General Surgery, University of Cape Town and New Somerset Hospital and Hernia Interest Group of South Africa Executive Committee

Z Koto, Sefako Makgatho Health Sciences University

Hernia Interest Group of South Africa Executive Committee and Sefako Makgatho Health Sciences University, South Africa

R Oodit, University of Cape Town

Division of General Surgery, University of Cape Town and Hernia Interest Group of South Africa Executive Committee

J C Kloppers, University of Cape Town

Division of General Surgery, Groote Schuur Hospital, University of Cape Town and Hernia Interest Group of South Africa Executive Committee

Published
2021-12-08
How to Cite
Gouws, J., Nel, D., Bougard, H., Koto, Z., Oodit, R., & Kloppers, J. (2021). Compliance to the South African ventral hernia guidelines: inaugural results from the HIG(SA) registry. South African Journal of Surgery, 59(4), 145-148. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/3526
Section
Hernia Surgery