Charles A. Messa

Using crowdsourcing as a platform to evaluate lay perception of prophylactic mesh placement

BACKGROUNDnProphylactic mesh placement (PMP) at the time of open abdominal surgery has gained momentum over the last decade. However, there remains an identifiable gap in the literature regarding patient-reported outcomes and qualitative metrics. In effort to gauge the populations understanding or familiarity with PMP, this study provides an educational framework and uses crowdsourcing as a novel means to assess perception among the general population.nnnMETHODSnA cross-sectional survey study was conducted among the general public to elicit perspectives on PMP. An online crowdsourcing platform was used to capture responses to a questionnaire. Pearsons correlation coefficients, paired t-test, chi-square test, and Fishers exact tests were performed.nnnRESULTSnOf 433 respondents, 338 (78.1%) were included. Individuals who had previously undergone surgery and those who had prior hernia repair were more likely to choose PMP than surgically naïve patients (Pxa0=xa00.06).nnnCONCLUSIONSnThe majority of respondents support the use of PMP. This study contributes to the existing body of literature on PMP and serves as the first qualitative description to gauge the populations perception and understanding of this surgical technique. Within the evolving health care landscape, understanding quality-of-life measures have become increasingly important in defining successful surgical outcomes. Although the data-driven level-I evidence supports the clinical use of PMP, this study intends to establish a framework for future patient-reported outcome studies.

Role of Prophylactic Mesh Placement for Laparotomy and Stoma Creation

Incisional and parastomal hernias are a cause of significant morbidity and have a substantial effect on quality of life and economic costs for patients and hospital systems. Although many aspects of abdominal hernias are understood, prevention is a feature that is still being realized. This article reviews the current literature and determines the utility of prophylactic mesh placement in prevention of incisional and parastomal hernias.

Abstract: Institutional Experience with Ultrasonic Debridement for the Treatment of Complex Wounds

BACKGROUND: Regret after gender-affirming surgery is considered a rare outcome. There is a paucity of literature examining the incidence and/or etiology of surgical deand re-transition. Coupled with the current issues in access and barriers for those seeking gender-affirming surgery, research in this field is extremely controversial. There are currently no professional guidelines or resources for providers who encounter patients who experience regret and/or seek detransition. In this paper the authors try to answer the question of how frequently gender surgeons are confronted with patients seeking the above care and what the current controversies are surrounding this very important topic.

Prophylactic mesh augmentation: Patient selection, techniques, and early outcomes

BACKGROUNDnIncisional hernias (IH) following abdominal surgery are frequent and morbid. Prophylactic mesh augmentation (PMA) has emerged as a technique to reduce IH formation. We aim to report patient selection, techniques and early outcomes after PMA.nnnMETHODSnRetrospective chart review identified descriptive characteristics, risk factors, operative technique, and early post-operative outcomes for PMA patients and matched non-PMA patients between January 1, 2016 and October 31, 2017.nnnRESULTSn18 consecutive PMA cases were performed (55.6% female, mean age 54.3 years and mean BMIu202f=u202f29.5u202fkg/m2). 88.9% of patients had at least two high-risk features for IH. Zero PMA patients developed IH compared to 5.3% non-PMA patients (pu202f=u202f0.314) (6-months mean follow-up). No difference in surgical site occurrences (SSO) were identified between the two groups.nnnCONCLUSIONSnEarly results are encouraging, demonstrating PMA is safe with equivocal SSO. Further studies are needed to assess if the reduction in IH formation is statistically significant with longer follow-up.