American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Videos from Tuesday's Editions

Bedside automated decision support system associated with 37 percent decline in hospital mortality

David H. Berger, MD, FACS, MHCM
Houston, TX

Implementation of an automated, continuously available bedside decision support system was associated with a 37 percent decrease in hospital mortality, Dr. Berger reported. The web-based clinical surveillance and decision support system alerted all members of the care team to deteriorating patient status via continuously displayed updated vital signs, lab data, bundles of care and NEWS (National Early Warning Score).

‘Lap Nissen’ more effective than second-line meds in patients with heartburn refractory to PPIs

John G. Hunter, MD, FACS
Portland, OR

Currently, proton pump inhibitors (PPI) don’t help about a third of persistent-heartburn patients with gastroesophageal reflux disease (GERD). In his study, Dr. John Hunter found that a surgical treatment, commonly known as Lap Nissen, achieved better symptom relief than medical therapy – including baclofen and desipramine -- for these patients.

Breast cancer panel eyes future treatments based on tumor genomic ‘footprint’

Susan Boolbol, MD, FACS
New York, NY

Dr. Susan Boolbo discusses the personalized care of breast cancer using genomic assay and the future of breast cancer treatments. Based on her studies, she hopes the treatments will transition from general regimens, and will instead be based on genomic assays or footprints.

Firearms panel calls for public health approach; surgeon member recalls handgun wound at 17

Joseph Sakran, MD, FACS
Baltimore, MD

There has been much talk about gun violence and gun safety, but little constructive, engaged dialogue between those concerned about gun violence and those concerned about gun rights. Dr. Joseph Sakran discusses what needs to be done regarding firearm injury in the United States.

AAA stent repair, open surgery result in similar long-term survival

Julie A. Freischlag, MD, FACS
Winston-Salem, NC

Extended follow-up of endovascular, or stent implantation, repair (EVR) of abdominal aortic aneurysm (AAA), vs. open surgical repair did not confirm worse late performance by EVR found in two European trials, said Dr. Julie Freischlag. The two achieved similar long-term survival, though the EVR group needed more secondary procedures.

Drones successfully deliver telemedicine to remote Mexican communities in feasibility study

Sharon Wulfovich
San Diego, CA

Drones have important potential to deliver telemedicine to remote communities around the world, said Sharon Wulfovich, a first-year medical student at University of California-San Diego. In a feasibility study her team sent more than 100 drones equipped with telemedicine gear to four remote Mexican communities. Average trip was 6.5 miles.

Residency culture study shines light on gender issues, need for better mentorship

Julie K. Johnson, MSPH, PhD
Chicago, IL

Policy recommendations from the FIRST qualitative study on improving the culture of surgical residency include greater vigilance against gender bias, adding mentoring resources, cutting paperwork and maintaining the 80-hour work week, said Julie K. Johnson, reporting results of the 98-interview study.

Mastery in General Surgery: A sixth year to add experience in, out of operating room

Fred Luchette MD, FACS, MSc, FCCM
Maywood, IL

Some graduate general surgery residents seek a sixth year of supervision by attendings, although looser than in residency itself. That path is offered through the Mastery in General Surgery (MGS) program, which enables more repetitions and more independence but still a measure of support, said Fred Luchette, MD, FACS, MSc, FCCM. His program at Loyola University of Chicago offers the MGS.

It takes a team to drive toward zero surgical-site infections

Tracy L. Hull, MD, FACS
Cleveland, OH

Historically and perhaps unsurprisingly, the colorectal field has had the highest rate of surgical-site infection in general surgery. That rate has come down dramatically since 2000, thanks to teamwork both in and out of the OR and “bundles” – antiseptic routines run diligently across multiple phases of care, said Dr. Tracy L. Hull.