We want to share this Cochrane review: Mesh versus non‐mesh for emergency groin hernia repair.

Objectives: To assess the benefits and harms of mesh compared with non‐mesh in emergency groin hernia repair in adult patients with an inguinal or femoral hernia. 

Main results: Fifteen trials with 1241 participants were included.

Participants underwent emergency groin hernia repair, either with insertion of a synthetic mesh or with sutures only.

For all outcomes, the certainty of evidence was considered very low. The main reasons for downgrading were high risk of bias, indirectness, and imprecision.

• Mesh hernia repair may slightly increase or have no effect on the risk of 30‐day surgical site infections. The absolute risk of surgical site infections was 107 per 1000 participants in the non-mesh group and 177 per 1000 participants in the mesh-group. However, the confidence intervals were wide, and the certainty of evidence was very low.
• Mesh removal was needed for seven participants, but all had a dirty surgical field at time of hernia repair. No mesh removal was needed for participants with a clean or clean-contaminated field.

Authors' conclusion: There is a need for high-quality studies regarding use of mesh in emergency hernia surgery. It is essential to assess and report the degree of contamination of the surgical fields, particularly for patients with contaminated to dirty surgical fields.

Access publication here: https://doi.org//10.1002/14651858.CD015160.pub2