Overall rate of ventral hernia mesh salvage was < 10%, but success rates were higher where lighter
polypropylene mesh was used (33%) and lower with the heavier polytetrafuoroethlyne mesh (8%).
Infected hernia salvage: Light
mesh ups odds for success
A nuanced approach
BY LISA NEWMAN, M.D., FACS
The screening mammography debate has been re- kindled by the American Cancer Society’s updated guideline released in October 2015. Surgeons are now
looking at yet another iteration of the optimal surveillance
schedule aimed at reducing breast cancer mortality.
Nearly all breast cancer patients undergo surgery as
at least one component of their care through diagnostic
biopsy and/or defnitive locoregional management, and
many women are referred to surgeons for evaluation as
well as follow-up for a variety of benign breast problems.
The discussion of breast cancer screening with patients can
be complicated by the many guidelines with conficting
recommendations, not to mention patient fears triggered
by incompletely informed or simplistic media coverage.
Surgeons are therefore obliged to remain knowledgeable
regarding the status and rationale for breast cancer screening guidelines that have been developed by our colleagues
in the American Cancer Society as well as other organizations.
Context of the updated guideline
The American Cancer Society and the American College
of Surgeons have historically advocated in favor of annual screening mammography for average-risk women in
VOL. 11 • NO. 12
Pre s orte d Sta n d ard
banon Jct. K Y
A C S Surgery N e ws C H A N G E SE R VIC E R E Q U ES T E D
151 Fairchild Ave.,
S uite 2,
Plainvie w, N Y 11803-1709
See Mammogram Â page 4
2 l Commentary
Dr. Peter Angelos offers a
tribute to the late Norman W.
Thompson, M.D., FACS.
10 l General Surgery
Dr. F. Paul Buckley III reports on patient
experience with a magnetic sphincter
device for GERD.
22 l Surgical Oncology
contralateral mastectomy was
debated at the Clinical Congress.
Online & In-Depth
Dr. Soumya Reddy discusses improvement of
psoriasis and psoriatic arthritis in a follow-up
study of bariatric surgery patients and its
possible mechanisms for this phenomenon.
BY M. ALEXANDER OTTO
Frontline Medical News
AT THE ACS CLINICAL CONGRESS
CHICAGO – Infected ventral hernia mesh is
most likely to be salvaged if it’s made from
lightweight polypropylene, according to data
from a series of 161 mesh infection cases at
Carolinas Medical Center in Charlotte, N.C.,
presented at the ACS Clinical Congress.
Investigators there were able to salvage
33% of lightweight polypropylene and 8%
of polytetrafuoroethylene mesh patients,
ite, polyester, or heavyweight polypropylene
meshes. The overall salvage rate was less than
“We sometimes think that we’ve salvaged
the mesh, but if we follow these patients long
enough” – follow-up was an average of 37
months in the series – “the majority of them
will need to be excised,” said investigator Dr.
Vedra Augenstein of the department of surgery at the medical center.
Wound complications are common in
See Mesh Â page 8
Recommendations differ by organization.
Global Surgery – Operation Giving Back
New directions for volunteerism
Dr. Girma Tefera’s vision for Operation Giving Back includes
partnering with international health organizations, better training
for volunteers, and more opportunities to participate in U.S.-based
programs. Â p. 3