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Recording mesh use in elective hernia repair operative notes and discharge summaries: A retrospective review of documentation

Author: 
Dr. Madeleine Garner, Mr. Kamil Naidoo, Umar J Wali and Glen Husada
Subject Area: 
Health Sciences
Abstract: 

In the UK, abdominal wall hernias of all types have a prevalence of 1.7% in patients of any age and 4% in those aged over 45 years. Despite the established gold standard of repair with prosthetic mesh, there are instances where a mesh is not used. It is therefore prudent that operation notes and discharge summaries contain information on the use (or indeed, absence) of prosthetic mesh, to aid diagnosis in the event of any subsequent complications and to guide further management. This retrospective study aims to review the documentation with a view to establishing current reporting practice. Method: All patients who underwent elective open abdominal wall hernia repair (incisional, umbilical/paraumbilical and inguinal), in a London district general hospital, from January 2016 to January 2017 were included in the study. Results: 53 cases meeting the inclusion criteria were identified with 2 cases excluded. All cases contained explicit operative documentation regarding prosthetic mesh (48 mesh repairs and 3 repairs without mesh.) Only 64.7% (n=33) discharge summaries contained explicit information on whether on not mesh was used. Conclusion: This study has found that there is sufficient documentation in operation notes, but a lack of mesh information in discharge summaries. The authors therefore recommend the operative surgeon guides junior staff on the information required on discharge summaries.

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