In SSA, delays in presentation and lack of surgical capacity often result in a higher proportion of complicated paediatric hernias. In Nigeria, outcomes have been reported as: mortality 2.4%, intestinal resection 7%, testicular gangrene 15% and wound infection 15%. Another centre reported that in their cohort of infants presenting <42days of age, 52% were incarcerated, 36% required a bowel resection and 18% underwent an orchidectomy for testicular infarction. Strangulated hernias constitute 22% of the emergency visceral surgery in the Democratic Republic of the Congo. A randomised controlled trial in Nigeria reported a reduction in infection rate following PIHR from 4.8% to 0% with the use of prophylactic IV gentamycin at induction.