A 15-year-old girl is brought in by her mother for evaluation of a rash that developed following a “candling” treatment she underwent two weeks ago at a beauty spa.

The treatment, which was performed to eliminate scaling in her external ear canal, involved dripping hot wax from a burning candle into the external auditory meatus. The cooled wax was peeled away, along with the attached scaling. A new, asymptomatic, scaly rash has since appeared in the same area—far worse than the original.

There is no history of recent infection or joint pain, or family history of skin disease.

EXAMINATION
Heavy, uniform, white scaling on a salmon-colored base covers the external auditory meatus, extending 3 or 4 mm into the concha. Similar, milder changes are observed in the left ear.

There are scattered pits in three fingernails, white scaling in the scalp above and behind both ears, and faint pink scaly patches on both knees and elbows.

What is the diagnosis?

The patient’s primary care provider, it turns out, was treating the elbow and knee rashes with antifungal creams (to no avail). He hadn’t made the connection between her various skin problems. It was the acute manifestation in the ear that prompted a broader assessment of the patient’s condition—proving the maxim that to find a diagnosis, you have to look for it.

Given its mild nature, this patient’s condition was easily treated with topical steroids and vitamin D-derived cream (calcipotriene). She was advised of the need to avoid exacerbating factors, such as smoking, obesity, excess alcohol intake, and stress.

There is the possibility of the disease worsening despite treatment. The patient also has about a 25% chance of developing psoriatic arthropathy. For these reasons, she will need to be followed by dermatology.

TAKE-HOME LEARNING POINTS

• Psoriasis, though very common, does not always manifest in its typical form.
• Any trauma (ie, burn, scrape, or cut) can trigger preexisting psoriasis, a response called the Koebner phenomenon.
• Several other conditions—including lichen planus, warts, and molluscum—can exhibit this same phenomenon.
• When psoriasis is suspected, potential corroboratory sites of involvement (eg, knees, elbows, nails, and scalp) should be examined. Biopsy is often needed to confirm the diagnosis.

A 15-year-old girl is brought in by her mother for evaluation of a rash that developed following a “candling” treatment she underwent two weeks ago at a beauty spa.

The treatment, which was performed to eliminate scaling in her external ear canal, involved dripping hot wax from a burning candle into the external auditory meatus. The cooled wax was peeled away, along with the attached scaling. A new, asymptomatic, scaly rash has since appeared in the same area—far worse than the original.

There is no history of recent infection or joint pain, or family history of skin disease.

EXAMINATION
Heavy, uniform, white scaling on a salmon-colored base covers the external auditory meatus, extending 3 or 4 mm into the concha. Similar, milder changes are observed in the left ear.

There are scattered pits in three fingernails, white scaling in the scalp above and behind both ears, and faint pink scaly patches on both knees and elbows.

What is the diagnosis?

The patient’s primary care provider, it turns out, was treating the elbow and knee rashes with antifungal creams (to no avail). He hadn’t made the connection between her various skin problems. It was the acute manifestation in the ear that prompted a broader assessment of the patient’s condition—proving the maxim that to find a diagnosis, you have to look for it.

Given its mild nature, this patient’s condition was easily treated with topical steroids and vitamin D-derived cream (calcipotriene). She was advised of the need to avoid exacerbating factors, such as smoking, obesity, excess alcohol intake, and stress.

There is the possibility of the disease worsening despite treatment. The patient also has about a 25% chance of developing psoriatic arthropathy. For these reasons, she will need to be followed by dermatology.

TAKE-HOME LEARNING POINTS

• Psoriasis, though very common, does not always manifest in its typical form.
• Any trauma (ie, burn, scrape, or cut) can trigger preexisting psoriasis, a response called the Koebner phenomenon.
• Several other conditions—including lichen planus, warts, and molluscum—can exhibit this same phenomenon.
• When psoriasis is suspected, potential corroboratory sites of involvement (eg, knees, elbows, nails, and scalp) should be examined. Biopsy is often needed to confirm the diagnosis.

A 15-year-old girl is brought in by her mother for evaluation of a rash that developed following a “candling” treatment she underwent two weeks ago at a beauty spa.

The treatment, which was performed to eliminate scaling in her external ear canal, involved dripping hot wax from a burning candle into the external auditory meatus. The cooled wax was peeled away, along with the attached scaling. A new, asymptomatic, scaly rash has since appeared in the same area—far worse than the original.

There is no history of recent infection or joint pain, or family history of skin disease.

EXAMINATION
Heavy, uniform, white scaling on a salmon-colored base covers the external auditory meatus, extending 3 or 4 mm into the concha. Similar, milder changes are observed in the left ear.

There are scattered pits in three fingernails, white scaling in the scalp above and behind both ears, and faint pink scaly patches on both knees and elbows.

What is the diagnosis?

The patient’s primary care provider, it turns out, was treating the elbow and knee rashes with antifungal creams (to no avail). He hadn’t made the connection between her various skin problems. It was the acute manifestation in the ear that prompted a broader assessment of the patient’s condition—proving the maxim that to find a diagnosis, you have to look for it.

Given its mild nature, this patient’s condition was easily treated with topical steroids and vitamin D-derived cream (calcipotriene). She was advised of the need to avoid exacerbating factors, such as smoking, obesity, excess alcohol intake, and stress.

There is the possibility of the disease worsening despite treatment. The patient also has about a 25% chance of developing psoriatic arthropathy. For these reasons, she will need to be followed by dermatology.

TAKE-HOME LEARNING POINTS

• Psoriasis, though very common, does not always manifest in its typical form.
• Any trauma (ie, burn, scrape, or cut) can trigger preexisting psoriasis, a response called the Koebner phenomenon.
• Several other conditions—including lichen planus, warts, and molluscum—can exhibit this same phenomenon.
• When psoriasis is suspected, potential corroboratory sites of involvement (eg, knees, elbows, nails, and scalp) should be examined. Biopsy is often needed to confirm the diagnosis.

Ferrous sulfate drops

A trial comparing ferrous sulfate with iron polysaccharide complex to treat infants and young children with nutritional iron-deficiency anemia (IDA) has shown ferrous sulfate to be more effective at raising hemoglobin levels in this population, according to researchers.

Dozens of oral iron supplements exist for IDA treatment, ferrous sulfate being the most commonly used. Iron polysaccharide complex, however, may be better tolerated.

Investigators undertook the BESTIRON study (NCT01904864) to determine whether the iron complex was more efficacious than ferrous sulfate in increasing hemoglobin concentrations in infants and young children aged 9 to 48 months.

Up to 3% of children aged 1 to 2 years in the United States have IDA, as do millions worldwide. IDA is associated with impaired neurodevelopment in the young.

Inadequate dietary iron intake in this group is the most common cause of IDA. It most often results from excessive cow milk consumption and/or prolonged breastfeeding without appropriate iron supplementation.

For this study, investigators randomized 80 infants and young children with nutritional IDA to receive 3 mg/kg of ferrous sulfate (n=40) or iron complex (n=40) drops once daily for 12 weeks.

Patients had to have hemoglobin concentrations of 10 g/dL or less, mean corpuscular volumes of 70 fL or less, reticulocyte hemoglobin equivalents of 25 pg or less, and either serum ferritin level of 15 ng/mL or less or total iron-binding capacity of 425 μg/dL or greater.

And they could have no clinical or laboratory evidence of other causes of anemia.

All 80 patients were included in the primary analysis evaluating change in hemoglobin concentration during the 12 weeks after starting oral iron therapy.

Patient characteristics

Patient characteristics were similar between the groups. The mean age was 23 months and 55% were male.

Most patients (61%) were Hispanic white, 9% were non-Hispanic white, and 11% were black.

Ten patients in the ferrous sulfate group and 8 in the iron complex group had received a packed red blood cell transfusion prior to study enrollment.

Results

Fifty-nine patients completed all study visits, 28 in the ferrous sulfate group and 31 in the iron complex group.

Patients’ mean hemoglobin level in the ferrous sulfate group increased from 7.9 g/dL to 11.9 g/dL over the 12 weeks. In the iron complex group, the patients’ hemoglobin level increased from 7.7 g/dL to 11.1 g/dL.

Using a linear mixed model, the primary outcome demonstrated a significant difference in the change in hemoglobin concentration of 1.0 g/dL (95% CI, 0.4-1.6; P < .001) between the groups, favoring ferrous sulfate.

IDA completely resolved in 8 of 28 (29%) patients in the ferrous sulfate group and 2 of 31 (6%) in the iron complex group (P=0.04).

However, successful administration of the supplement—meaning he child did not spit out the medication—was higher in the iron complex group (94%) than the iron sulfate group (82%), P=0.009.

The median serum ferritin level increased from 3.0 ng/mL to 15.6 ng/mL in the ferrous sulfate arm, which was significantly better than in the iron complex arm, which increased from 2.0 ng/mL to 7.5 ng/mL, P<0.001.

And the mean total iron binding capacity significantly increased in the ferrous sulfate group compared with the iron oxide group (P<0.001).

Safety

The investigators reported that patients treated with iron complex had significantly more diahrrea, while patients treated with ferrous sulfate had more vomiting, although the latter was not statistically significant.

A gastrointestinal adverse effect profile created at the end of the study showed no significant differences between the groups.

The investigators noted a few limitations of the study.

First, it was conducted in a single tertiary-care children’s hospital, the Children’s Medical Center in Dallas, Texas.

Second, a disproportionate number of patients were from lower income and minority families and frequently had severe anemia, with approximately 23% requiring blood transfusion prior to study start.

And third, the trial had a high lost-to-follow-up rate of 25% at the final visit.

So the results may not be generalizable to the general pediatric population.

Nevertheless, the investigators concluded, “Once daily, low-dose ferrous sulfate should be considered for children with nutritional iron-deficiency anemia.”

The team reported their findings in JAMA.

The study was an investigator-initiated trial with sponsorship from Gensavis Pharmaceuticals LLC, the manufacturer of the iron polysaccharide complex used in the trial. The company provided funding for both trial drugs.

The study received additional grant support from the National Center for Advancing Translational Sciences and the National Heart, Lung, and Blood Institute. 

Ferrous sulfate drops

A trial comparing ferrous sulfate with iron polysaccharide complex to treat infants and young children with nutritional iron-deficiency anemia (IDA) has shown ferrous sulfate to be more effective at raising hemoglobin levels in this population, according to researchers.

Dozens of oral iron supplements exist for IDA treatment, ferrous sulfate being the most commonly used. Iron polysaccharide complex, however, may be better tolerated.

Investigators undertook the BESTIRON study (NCT01904864) to determine whether the iron complex was more efficacious than ferrous sulfate in increasing hemoglobin concentrations in infants and young children aged 9 to 48 months.

Up to 3% of children aged 1 to 2 years in the United States have IDA, as do millions worldwide. IDA is associated with impaired neurodevelopment in the young.

Inadequate dietary iron intake in this group is the most common cause of IDA. It most often results from excessive cow milk consumption and/or prolonged breastfeeding without appropriate iron supplementation.

For this study, investigators randomized 80 infants and young children with nutritional IDA to receive 3 mg/kg of ferrous sulfate (n=40) or iron complex (n=40) drops once daily for 12 weeks.

Patients had to have hemoglobin concentrations of 10 g/dL or less, mean corpuscular volumes of 70 fL or less, reticulocyte hemoglobin equivalents of 25 pg or less, and either serum ferritin level of 15 ng/mL or less or total iron-binding capacity of 425 μg/dL or greater.

And they could have no clinical or laboratory evidence of other causes of anemia.

All 80 patients were included in the primary analysis evaluating change in hemoglobin concentration during the 12 weeks after starting oral iron therapy.

Patient characteristics

Patient characteristics were similar between the groups. The mean age was 23 months and 55% were male.

Most patients (61%) were Hispanic white, 9% were non-Hispanic white, and 11% were black.

Ten patients in the ferrous sulfate group and 8 in the iron complex group had received a packed red blood cell transfusion prior to study enrollment.

Results

Fifty-nine patients completed all study visits, 28 in the ferrous sulfate group and 31 in the iron complex group.

Patients’ mean hemoglobin level in the ferrous sulfate group increased from 7.9 g/dL to 11.9 g/dL over the 12 weeks. In the iron complex group, the patients’ hemoglobin level increased from 7.7 g/dL to 11.1 g/dL.

Using a linear mixed model, the primary outcome demonstrated a significant difference in the change in hemoglobin concentration of 1.0 g/dL (95% CI, 0.4-1.6; P < .001) between the groups, favoring ferrous sulfate.

IDA completely resolved in 8 of 28 (29%) patients in the ferrous sulfate group and 2 of 31 (6%) in the iron complex group (P=0.04).

However, successful administration of the supplement—meaning he child did not spit out the medication—was higher in the iron complex group (94%) than the iron sulfate group (82%), P=0.009.

The median serum ferritin level increased from 3.0 ng/mL to 15.6 ng/mL in the ferrous sulfate arm, which was significantly better than in the iron complex arm, which increased from 2.0 ng/mL to 7.5 ng/mL, P<0.001.

And the mean total iron binding capacity significantly increased in the ferrous sulfate group compared with the iron oxide group (P<0.001).

Safety

The investigators reported that patients treated with iron complex had significantly more diahrrea, while patients treated with ferrous sulfate had more vomiting, although the latter was not statistically significant.

A gastrointestinal adverse effect profile created at the end of the study showed no significant differences between the groups.

The investigators noted a few limitations of the study.

First, it was conducted in a single tertiary-care children’s hospital, the Children’s Medical Center in Dallas, Texas.

Second, a disproportionate number of patients were from lower income and minority families and frequently had severe anemia, with approximately 23% requiring blood transfusion prior to study start.

And third, the trial had a high lost-to-follow-up rate of 25% at the final visit.

So the results may not be generalizable to the general pediatric population.

Nevertheless, the investigators concluded, “Once daily, low-dose ferrous sulfate should be considered for children with nutritional iron-deficiency anemia.”

The team reported their findings in JAMA.

The study was an investigator-initiated trial with sponsorship from Gensavis Pharmaceuticals LLC, the manufacturer of the iron polysaccharide complex used in the trial. The company provided funding for both trial drugs.

The study received additional grant support from the National Center for Advancing Translational Sciences and the National Heart, Lung, and Blood Institute. 

Ferrous sulfate drops

A trial comparing ferrous sulfate with iron polysaccharide complex to treat infants and young children with nutritional iron-deficiency anemia (IDA) has shown ferrous sulfate to be more effective at raising hemoglobin levels in this population, according to researchers.

Dozens of oral iron supplements exist for IDA treatment, ferrous sulfate being the most commonly used. Iron polysaccharide complex, however, may be better tolerated.

Investigators undertook the BESTIRON study (NCT01904864) to determine whether the iron complex was more efficacious than ferrous sulfate in increasing hemoglobin concentrations in infants and young children aged 9 to 48 months.

Up to 3% of children aged 1 to 2 years in the United States have IDA, as do millions worldwide. IDA is associated with impaired neurodevelopment in the young.

Inadequate dietary iron intake in this group is the most common cause of IDA. It most often results from excessive cow milk consumption and/or prolonged breastfeeding without appropriate iron supplementation.

For this study, investigators randomized 80 infants and young children with nutritional IDA to receive 3 mg/kg of ferrous sulfate (n=40) or iron complex (n=40) drops once daily for 12 weeks.

Patients had to have hemoglobin concentrations of 10 g/dL or less, mean corpuscular volumes of 70 fL or less, reticulocyte hemoglobin equivalents of 25 pg or less, and either serum ferritin level of 15 ng/mL or less or total iron-binding capacity of 425 μg/dL or greater.

And they could have no clinical or laboratory evidence of other causes of anemia.

All 80 patients were included in the primary analysis evaluating change in hemoglobin concentration during the 12 weeks after starting oral iron therapy.

Patient characteristics

Patient characteristics were similar between the groups. The mean age was 23 months and 55% were male.

Most patients (61%) were Hispanic white, 9% were non-Hispanic white, and 11% were black.

Ten patients in the ferrous sulfate group and 8 in the iron complex group had received a packed red blood cell transfusion prior to study enrollment.

Results

Fifty-nine patients completed all study visits, 28 in the ferrous sulfate group and 31 in the iron complex group.

Patients’ mean hemoglobin level in the ferrous sulfate group increased from 7.9 g/dL to 11.9 g/dL over the 12 weeks. In the iron complex group, the patients’ hemoglobin level increased from 7.7 g/dL to 11.1 g/dL.

Using a linear mixed model, the primary outcome demonstrated a significant difference in the change in hemoglobin concentration of 1.0 g/dL (95% CI, 0.4-1.6; P < .001) between the groups, favoring ferrous sulfate.

IDA completely resolved in 8 of 28 (29%) patients in the ferrous sulfate group and 2 of 31 (6%) in the iron complex group (P=0.04).

However, successful administration of the supplement—meaning he child did not spit out the medication—was higher in the iron complex group (94%) than the iron sulfate group (82%), P=0.009.

The median serum ferritin level increased from 3.0 ng/mL to 15.6 ng/mL in the ferrous sulfate arm, which was significantly better than in the iron complex arm, which increased from 2.0 ng/mL to 7.5 ng/mL, P<0.001.

And the mean total iron binding capacity significantly increased in the ferrous sulfate group compared with the iron oxide group (P<0.001).

Safety

The investigators reported that patients treated with iron complex had significantly more diahrrea, while patients treated with ferrous sulfate had more vomiting, although the latter was not statistically significant.

A gastrointestinal adverse effect profile created at the end of the study showed no significant differences between the groups.

The investigators noted a few limitations of the study.

First, it was conducted in a single tertiary-care children’s hospital, the Children’s Medical Center in Dallas, Texas.

Second, a disproportionate number of patients were from lower income and minority families and frequently had severe anemia, with approximately 23% requiring blood transfusion prior to study start.

And third, the trial had a high lost-to-follow-up rate of 25% at the final visit.

So the results may not be generalizable to the general pediatric population.

Nevertheless, the investigators concluded, “Once daily, low-dose ferrous sulfate should be considered for children with nutritional iron-deficiency anemia.”

The team reported their findings in JAMA.

The study was an investigator-initiated trial with sponsorship from Gensavis Pharmaceuticals LLC, the manufacturer of the iron polysaccharide complex used in the trial. The company provided funding for both trial drugs.

The study received additional grant support from the National Center for Advancing Translational Sciences and the National Heart, Lung, and Blood Institute. 

The FP did a 4-mm punch biopsy to confirm that this was a case of prurigo nodularis and prescribed clobetasol cream to be applied twice daily to the pruritic nodules. The FP recommended that the patient apply the cream instead of scratching the area. The FP also said that if the patient couldn’t avoid touching the area, it would be better to lightly rub the area over his clothing instead.

The biopsy results subsequently confirmed a diagnosis of prurigo nodularis. At the patient’s 2-week follow-up, he indicated that his symptoms were 50% better since using the clobetasol. The FP explained to the patient the nature of prurigo nodularis, including the patient’s itch-scratch cycle and how stress was making it worse. The patient acknowledged that his symptoms had become worse when he began having financial trouble. The FP asked the patient if he wanted to see a counselor, but the patient declined, saying that he just needed to get more work.

At a one-month follow-up, 90% of the nodules were resolved, although there were still some stubborn areas that continued to itch. The patient could not control scratching these areas at times. The FP offered intralesional injections with triamcinolone and/or cryotherapy. The patient consented to liquid nitrogen therapy and the remaining nodules were frozen for approximately 10 seconds each using a liquid nitrogen spray.

Four weeks later, the patient had 4 remaining nodules. The FP injected the nodules with 10 mg/mL triamcinolone and refilled the clobetasol cream. At the next appointment, 2 nodules remained. The patient indicated that he would continue using the cream until the nodules went away. In many cases, prurigo nodularis does not respond especially well to treatment, so this patient was fortunate that standard treatments provided a good outcome.

Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Usatine R, Johnson A. Self-inflicted dermatosis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013: 856-862.

To learn more about the Color Atlas of Family Medicine, see: www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: usatinemedia.com

The FP did a 4-mm punch biopsy to confirm that this was a case of prurigo nodularis and prescribed clobetasol cream to be applied twice daily to the pruritic nodules. The FP recommended that the patient apply the cream instead of scratching the area. The FP also said that if the patient couldn’t avoid touching the area, it would be better to lightly rub the area over his clothing instead.

The biopsy results subsequently confirmed a diagnosis of prurigo nodularis. At the patient’s 2-week follow-up, he indicated that his symptoms were 50% better since using the clobetasol. The FP explained to the patient the nature of prurigo nodularis, including the patient’s itch-scratch cycle and how stress was making it worse. The patient acknowledged that his symptoms had become worse when he began having financial trouble. The FP asked the patient if he wanted to see a counselor, but the patient declined, saying that he just needed to get more work.

At a one-month follow-up, 90% of the nodules were resolved, although there were still some stubborn areas that continued to itch. The patient could not control scratching these areas at times. The FP offered intralesional injections with triamcinolone and/or cryotherapy. The patient consented to liquid nitrogen therapy and the remaining nodules were frozen for approximately 10 seconds each using a liquid nitrogen spray.

Four weeks later, the patient had 4 remaining nodules. The FP injected the nodules with 10 mg/mL triamcinolone and refilled the clobetasol cream. At the next appointment, 2 nodules remained. The patient indicated that he would continue using the cream until the nodules went away. In many cases, prurigo nodularis does not respond especially well to treatment, so this patient was fortunate that standard treatments provided a good outcome.

Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Usatine R, Johnson A. Self-inflicted dermatosis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013: 856-862.

To learn more about the Color Atlas of Family Medicine, see: www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: usatinemedia.com

The FP did a 4-mm punch biopsy to confirm that this was a case of prurigo nodularis and prescribed clobetasol cream to be applied twice daily to the pruritic nodules. The FP recommended that the patient apply the cream instead of scratching the area. The FP also said that if the patient couldn’t avoid touching the area, it would be better to lightly rub the area over his clothing instead.

The biopsy results subsequently confirmed a diagnosis of prurigo nodularis. At the patient’s 2-week follow-up, he indicated that his symptoms were 50% better since using the clobetasol. The FP explained to the patient the nature of prurigo nodularis, including the patient’s itch-scratch cycle and how stress was making it worse. The patient acknowledged that his symptoms had become worse when he began having financial trouble. The FP asked the patient if he wanted to see a counselor, but the patient declined, saying that he just needed to get more work.

At a one-month follow-up, 90% of the nodules were resolved, although there were still some stubborn areas that continued to itch. The patient could not control scratching these areas at times. The FP offered intralesional injections with triamcinolone and/or cryotherapy. The patient consented to liquid nitrogen therapy and the remaining nodules were frozen for approximately 10 seconds each using a liquid nitrogen spray.

Four weeks later, the patient had 4 remaining nodules. The FP injected the nodules with 10 mg/mL triamcinolone and refilled the clobetasol cream. At the next appointment, 2 nodules remained. The patient indicated that he would continue using the cream until the nodules went away. In many cases, prurigo nodularis does not respond especially well to treatment, so this patient was fortunate that standard treatments provided a good outcome.

Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Usatine R, Johnson A. Self-inflicted dermatosis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013: 856-862.

To learn more about the Color Atlas of Family Medicine, see: www.amazon.com/Color-Family-Medicine-Richard-Usatine/dp/0071769641/

You can now get the second edition of the Color Atlas of Family Medicine as an app by clicking on this link: usatinemedia.com

The American College of Surgeons (ACS) Committee on Diversity Issues (CODI) is seeking candidates to fill two vacancies on the committee beginning in October 2017.

The mission of the Committee on Diversity Issues is to study the educational and professional needs of underrepresented surgeons and surgical trainees and the impact that its work may have on the elimination of health care disparities among diverse population groups.

Surgeons interested in developing initiatives to expand diversity within the ACS membership and leadership and to developing resources and programming for surgeons related to diversity and cultural competency should apply. Nominations are open to all, and the committee encourages representation by individuals of diverse cultural, racial, and ethnic backgrounds.

Nominees must meet the following criteria:

• Be an active Fellow of the ACS
• Be able to serve an initial three-year term: 2017–2020
• Attend one in-person meeting at the annual ACS Clinical Congress
• Participate in quarterly conference calls
• Contribute to committee initiatives

To apply, go to www.surveymonkey.com/r/CmteDiversityApp to access the application and submit by June 30.

Applicants will need to do the following:

• Upload a summary of your curriculum vitae (five pages or less)
• Upload a letter of interest highlighting your skills and expertise, along with contributions you would like to make to the committee

Eligible candidates will be selected and notified by the committee in July and will be invited to attend the October 23 meeting of the Committee on Diversity Issues as guests. This meeting is held in conjunction with the 2017 Clinical Congress in San Diego. Travel reimbursement will not be provided.

Direct questions to [email protected].

The American College of Surgeons (ACS) Committee on Diversity Issues (CODI) is seeking candidates to fill two vacancies on the committee beginning in October 2017.

The mission of the Committee on Diversity Issues is to study the educational and professional needs of underrepresented surgeons and surgical trainees and the impact that its work may have on the elimination of health care disparities among diverse population groups.

Surgeons interested in developing initiatives to expand diversity within the ACS membership and leadership and to developing resources and programming for surgeons related to diversity and cultural competency should apply. Nominations are open to all, and the committee encourages representation by individuals of diverse cultural, racial, and ethnic backgrounds.

Nominees must meet the following criteria:

• Be an active Fellow of the ACS
• Be able to serve an initial three-year term: 2017–2020
• Attend one in-person meeting at the annual ACS Clinical Congress
• Participate in quarterly conference calls
• Contribute to committee initiatives

To apply, go to www.surveymonkey.com/r/CmteDiversityApp to access the application and submit by June 30.

Applicants will need to do the following:

• Upload a summary of your curriculum vitae (five pages or less)
• Upload a letter of interest highlighting your skills and expertise, along with contributions you would like to make to the committee

Eligible candidates will be selected and notified by the committee in July and will be invited to attend the October 23 meeting of the Committee on Diversity Issues as guests. This meeting is held in conjunction with the 2017 Clinical Congress in San Diego. Travel reimbursement will not be provided.

Direct questions to [email protected].

The American College of Surgeons (ACS) Committee on Diversity Issues (CODI) is seeking candidates to fill two vacancies on the committee beginning in October 2017.

The mission of the Committee on Diversity Issues is to study the educational and professional needs of underrepresented surgeons and surgical trainees and the impact that its work may have on the elimination of health care disparities among diverse population groups.

Surgeons interested in developing initiatives to expand diversity within the ACS membership and leadership and to developing resources and programming for surgeons related to diversity and cultural competency should apply. Nominations are open to all, and the committee encourages representation by individuals of diverse cultural, racial, and ethnic backgrounds.

Nominees must meet the following criteria:

• Be an active Fellow of the ACS
• Be able to serve an initial three-year term: 2017–2020
• Attend one in-person meeting at the annual ACS Clinical Congress
• Participate in quarterly conference calls
• Contribute to committee initiatives

To apply, go to www.surveymonkey.com/r/CmteDiversityApp to access the application and submit by June 30.

Applicants will need to do the following:

• Upload a summary of your curriculum vitae (five pages or less)
• Upload a letter of interest highlighting your skills and expertise, along with contributions you would like to make to the committee

Eligible candidates will be selected and notified by the committee in July and will be invited to attend the October 23 meeting of the Committee on Diversity Issues as guests. This meeting is held in conjunction with the 2017 Clinical Congress in San Diego. Travel reimbursement will not be provided.

Direct questions to [email protected].

The more we think we know, the less we actually may know. As new techniques develop and their use is closely examined and reported, details about the patient’s disease and the surgeon’s skill and judgment turn out to matter more and more in the decision-making process. So it is with acute cholecystitis.

I have recently been puzzled and intrigued by changing trends in the management of acute cholecystitis that are apparent in the medical literature, discussions in the ACS Communities, and practice in my local community.
 

When I was a resident, the debate about early cholecystectomy vs antibiotics with interval operation 6 weeks later was just being settled in the literature in favor of early cholecystectomy. The weight of evidence in the surgical literature found that delay made the eventual operation more difficult and costly.

Dr. Deveney is professor of surgery and vice chair of education in the department of surgery, Oregon Health & Science University, Portland. She is the coeditor of ACS Surgery News.

The more we think we know, the less we actually may know. As new techniques develop and their use is closely examined and reported, details about the patient’s disease and the surgeon’s skill and judgment turn out to matter more and more in the decision-making process. So it is with acute cholecystitis.

I have recently been puzzled and intrigued by changing trends in the management of acute cholecystitis that are apparent in the medical literature, discussions in the ACS Communities, and practice in my local community.
 

When I was a resident, the debate about early cholecystectomy vs antibiotics with interval operation 6 weeks later was just being settled in the literature in favor of early cholecystectomy. The weight of evidence in the surgical literature found that delay made the eventual operation more difficult and costly.

Dr. Deveney is professor of surgery and vice chair of education in the department of surgery, Oregon Health & Science University, Portland. She is the coeditor of ACS Surgery News.

The more we think we know, the less we actually may know. As new techniques develop and their use is closely examined and reported, details about the patient’s disease and the surgeon’s skill and judgment turn out to matter more and more in the decision-making process. So it is with acute cholecystitis.

I have recently been puzzled and intrigued by changing trends in the management of acute cholecystitis that are apparent in the medical literature, discussions in the ACS Communities, and practice in my local community.
 

When I was a resident, the debate about early cholecystectomy vs antibiotics with interval operation 6 weeks later was just being settled in the literature in favor of early cholecystectomy. The weight of evidence in the surgical literature found that delay made the eventual operation more difficult and costly.

Dr. Deveney is professor of surgery and vice chair of education in the department of surgery, Oregon Health & Science University, Portland. She is the coeditor of ACS Surgery News.

Since its foundation in 1913 as the premier surgical professional organization in the United States, and one of the most influential in the world, the American College of Surgeons has shaped the policies and molded the education of numerous generations of surgeons. All young surgeons should aspire to be invested as Fellows some day as the highest honor in their career.

Service is an important factor in the decision to become a surgeon. As a Fellow of the ACS, the young surgeon will find many opportunities for service. Active participation as a Fellow is an act of service and can be an act of love for our patients, our colleagues, and our profession. And, with it, comes loyalty, a spirit of dedication, and a sense of unity. In addition, by joining the College we contribute to influencing our society in a positive way to protect our patients and our profession.

Becoming an active participant in the College means serving on committees, attending the Clinical Congress as frequently as feasible, and encouraging colleagues to aspire to become a Fellow.

In the end, being a part of our College and contributing to its growth and legacy is an act of service and, for many, an act of love.

Dr. Oviedo is with Capital Regional Surgical Associates, Tallahassee, Fla., and is Assistant Professor of Surgery, Florida State University College of Medicine. He serves as the ACS Young Fellow Association Liaison.

Since its foundation in 1913 as the premier surgical professional organization in the United States, and one of the most influential in the world, the American College of Surgeons has shaped the policies and molded the education of numerous generations of surgeons. All young surgeons should aspire to be invested as Fellows some day as the highest honor in their career.

Service is an important factor in the decision to become a surgeon. As a Fellow of the ACS, the young surgeon will find many opportunities for service. Active participation as a Fellow is an act of service and can be an act of love for our patients, our colleagues, and our profession. And, with it, comes loyalty, a spirit of dedication, and a sense of unity. In addition, by joining the College we contribute to influencing our society in a positive way to protect our patients and our profession.

Becoming an active participant in the College means serving on committees, attending the Clinical Congress as frequently as feasible, and encouraging colleagues to aspire to become a Fellow.

In the end, being a part of our College and contributing to its growth and legacy is an act of service and, for many, an act of love.

Dr. Oviedo is with Capital Regional Surgical Associates, Tallahassee, Fla., and is Assistant Professor of Surgery, Florida State University College of Medicine. He serves as the ACS Young Fellow Association Liaison.

Since its foundation in 1913 as the premier surgical professional organization in the United States, and one of the most influential in the world, the American College of Surgeons has shaped the policies and molded the education of numerous generations of surgeons. All young surgeons should aspire to be invested as Fellows some day as the highest honor in their career.

Service is an important factor in the decision to become a surgeon. As a Fellow of the ACS, the young surgeon will find many opportunities for service. Active participation as a Fellow is an act of service and can be an act of love for our patients, our colleagues, and our profession. And, with it, comes loyalty, a spirit of dedication, and a sense of unity. In addition, by joining the College we contribute to influencing our society in a positive way to protect our patients and our profession.

Becoming an active participant in the College means serving on committees, attending the Clinical Congress as frequently as feasible, and encouraging colleagues to aspire to become a Fellow.

In the end, being a part of our College and contributing to its growth and legacy is an act of service and, for many, an act of love.

Dr. Oviedo is with Capital Regional Surgical Associates, Tallahassee, Fla., and is Assistant Professor of Surgery, Florida State University College of Medicine. He serves as the ACS Young Fellow Association Liaison.

The American College of Surgeons (ACS) Division of Education’s new Resources in Surgical Education (RISE) recently debuted on the ACS website. RISE is headed by Ajit K. Sachdeva, MD, FACS, FRCSC, Director, ACS Division of Education. The RISE web page is available at www.facs.org/education/division-of-education/publications/rise/current.

The American College of Surgeons (ACS) Division of Education’s new Resources in Surgical Education (RISE) recently debuted on the ACS website. RISE is headed by Ajit K. Sachdeva, MD, FACS, FRCSC, Director, ACS Division of Education. The RISE web page is available at www.facs.org/education/division-of-education/publications/rise/current.

The American College of Surgeons (ACS) Division of Education’s new Resources in Surgical Education (RISE) recently debuted on the ACS website. RISE is headed by Ajit K. Sachdeva, MD, FACS, FRCSC, Director, ACS Division of Education. The RISE web page is available at www.facs.org/education/division-of-education/publications/rise/current.

The 2017 American College of Surgeons (ACS) Leadership & Advocacy Summit, May 6–9 in Washington, DC, was a well-attended conference that brought together surgeons from across the U.S. to enhance their leadership skills and to learn about how they can advocate for the advancement of issues important to the field of surgery.

Leadership Summit

More than 450 surgeons and residents participated in the ACS Leadership Summit held May 6–7. The Leadership portion of the Leadership & Advocacy Summit included a series of presentations that provided practical, take-home tips on how to be a better leader. Presentations covered such diverse leadership topics as how to handle difficult conversations, manage difficult people, and lead from behind; how it’s not all about you, and leading by example; volunteering in your own backyard; avoiding burnout and promoting resilience; preparing for leadership positions in medicine; and successfully addressing critical situations in the operating room. PowerPoint presentations shown at the 2017 Leadership Summit are available at facs.org/advocacy/participate/summit/2017-presentations.

In addition, ACS chapter leaders shared success stories. Representatives of the Connecticut Chapter focused on resident engagement, representatives of the North Texas Chapter and South Texas Chapter explained the positive results that can be realized by holding joint chapter meetings, and members of the Georgia Society of the ACS discussed their Stop the Bleed® effort. Participants then convened in state breakout sessions during the lunch hour to identify new strategies and initiatives for implementation at the chapter level. ACS Executive Director David B. Hoyt, MD, FACS, provided an update on ACS activities.

Advocacy Summit

More than 300 surgeons and residents participated in the ACS Advocacy Summit, May 7−9. Participants in the Advocacy Summit portion of the ACS Leadership & Advocacy Summit came to Washington primarily to meet with lawmakers and congressional staff to educate them about key ACS legislative priorities that affect surgical patients, including ensuring an adequate surgical workforce in underserved areas; advancing childhood cancer research and surveillance and providing resources for pediatric cancer survivors; allocating funding for the Children’s Health Insurance Program, which provides health care coverage to uninsured children from low-income families; improving liability protections for trauma care providers; and providing greater flexibility for providers during implementation of the Merit-based Incentive Payment System (MIPS). The issue briefs presented during the Advocacy Summit are available on the ACS Professional Association website at web4.facs.org/eBusiness/login.aspx?ReturnURL=~/SAML/SSOService.aspx?r=1.

In addition, health care reform was discussed during a few panel sessions. Just days before the Advocacy Summit, the House of Representatives had passed the American Health Care Act by a vote of 217-213. Summit attendees were educated about the College’s concerns with the legislation and were advised that the Senate bill likely would be dramatically different. The College continues to work to ensure that ACS health care reform principles—patient safety and quality, patient access to surgical care, reduction of health care costs and medical liability reform—are included in a revised Senate bill. The full ACS 2017 statement on health care reform was published in the May issue of the Bulletin and is available at bulletin.facs.org/2017/05/american-college-of-surgeons-2017-statement-on-health-care-reform/.

The 2017 American College of Surgeons (ACS) Leadership & Advocacy Summit, May 6–9 in Washington, DC, was a well-attended conference that brought together surgeons from across the U.S. to enhance their leadership skills and to learn about how they can advocate for the advancement of issues important to the field of surgery.

Leadership Summit

More than 450 surgeons and residents participated in the ACS Leadership Summit held May 6–7. The Leadership portion of the Leadership & Advocacy Summit included a series of presentations that provided practical, take-home tips on how to be a better leader. Presentations covered such diverse leadership topics as how to handle difficult conversations, manage difficult people, and lead from behind; how it’s not all about you, and leading by example; volunteering in your own backyard; avoiding burnout and promoting resilience; preparing for leadership positions in medicine; and successfully addressing critical situations in the operating room. PowerPoint presentations shown at the 2017 Leadership Summit are available at facs.org/advocacy/participate/summit/2017-presentations.

In addition, ACS chapter leaders shared success stories. Representatives of the Connecticut Chapter focused on resident engagement, representatives of the North Texas Chapter and South Texas Chapter explained the positive results that can be realized by holding joint chapter meetings, and members of the Georgia Society of the ACS discussed their Stop the Bleed® effort. Participants then convened in state breakout sessions during the lunch hour to identify new strategies and initiatives for implementation at the chapter level. ACS Executive Director David B. Hoyt, MD, FACS, provided an update on ACS activities.

Advocacy Summit

More than 300 surgeons and residents participated in the ACS Advocacy Summit, May 7−9. Participants in the Advocacy Summit portion of the ACS Leadership & Advocacy Summit came to Washington primarily to meet with lawmakers and congressional staff to educate them about key ACS legislative priorities that affect surgical patients, including ensuring an adequate surgical workforce in underserved areas; advancing childhood cancer research and surveillance and providing resources for pediatric cancer survivors; allocating funding for the Children’s Health Insurance Program, which provides health care coverage to uninsured children from low-income families; improving liability protections for trauma care providers; and providing greater flexibility for providers during implementation of the Merit-based Incentive Payment System (MIPS). The issue briefs presented during the Advocacy Summit are available on the ACS Professional Association website at web4.facs.org/eBusiness/login.aspx?ReturnURL=~/SAML/SSOService.aspx?r=1.

In addition, health care reform was discussed during a few panel sessions. Just days before the Advocacy Summit, the House of Representatives had passed the American Health Care Act by a vote of 217-213. Summit attendees were educated about the College’s concerns with the legislation and were advised that the Senate bill likely would be dramatically different. The College continues to work to ensure that ACS health care reform principles—patient safety and quality, patient access to surgical care, reduction of health care costs and medical liability reform—are included in a revised Senate bill. The full ACS 2017 statement on health care reform was published in the May issue of the Bulletin and is available at bulletin.facs.org/2017/05/american-college-of-surgeons-2017-statement-on-health-care-reform/.

The 2017 American College of Surgeons (ACS) Leadership & Advocacy Summit, May 6–9 in Washington, DC, was a well-attended conference that brought together surgeons from across the U.S. to enhance their leadership skills and to learn about how they can advocate for the advancement of issues important to the field of surgery.

Leadership Summit

More than 450 surgeons and residents participated in the ACS Leadership Summit held May 6–7. The Leadership portion of the Leadership & Advocacy Summit included a series of presentations that provided practical, take-home tips on how to be a better leader. Presentations covered such diverse leadership topics as how to handle difficult conversations, manage difficult people, and lead from behind; how it’s not all about you, and leading by example; volunteering in your own backyard; avoiding burnout and promoting resilience; preparing for leadership positions in medicine; and successfully addressing critical situations in the operating room. PowerPoint presentations shown at the 2017 Leadership Summit are available at facs.org/advocacy/participate/summit/2017-presentations.

In addition, ACS chapter leaders shared success stories. Representatives of the Connecticut Chapter focused on resident engagement, representatives of the North Texas Chapter and South Texas Chapter explained the positive results that can be realized by holding joint chapter meetings, and members of the Georgia Society of the ACS discussed their Stop the Bleed® effort. Participants then convened in state breakout sessions during the lunch hour to identify new strategies and initiatives for implementation at the chapter level. ACS Executive Director David B. Hoyt, MD, FACS, provided an update on ACS activities.

Advocacy Summit

More than 300 surgeons and residents participated in the ACS Advocacy Summit, May 7−9. Participants in the Advocacy Summit portion of the ACS Leadership & Advocacy Summit came to Washington primarily to meet with lawmakers and congressional staff to educate them about key ACS legislative priorities that affect surgical patients, including ensuring an adequate surgical workforce in underserved areas; advancing childhood cancer research and surveillance and providing resources for pediatric cancer survivors; allocating funding for the Children’s Health Insurance Program, which provides health care coverage to uninsured children from low-income families; improving liability protections for trauma care providers; and providing greater flexibility for providers during implementation of the Merit-based Incentive Payment System (MIPS). The issue briefs presented during the Advocacy Summit are available on the ACS Professional Association website at web4.facs.org/eBusiness/login.aspx?ReturnURL=~/SAML/SSOService.aspx?r=1.

In addition, health care reform was discussed during a few panel sessions. Just days before the Advocacy Summit, the House of Representatives had passed the American Health Care Act by a vote of 217-213. Summit attendees were educated about the College’s concerns with the legislation and were advised that the Senate bill likely would be dramatically different. The College continues to work to ensure that ACS health care reform principles—patient safety and quality, patient access to surgical care, reduction of health care costs and medical liability reform—are included in a revised Senate bill. The full ACS 2017 statement on health care reform was published in the May issue of the Bulletin and is available at bulletin.facs.org/2017/05/american-college-of-surgeons-2017-statement-on-health-care-reform/.

The American College of Surgeons Accredited Education Institutes (ACS-AEI) will host a forum June 12 that seeks to mobilize stakeholders to identify best practices and key considerations in simulation training and to build the case for more standardized implementation of simulation training and assessment in early-career surgical education. The forum, called “Training the Next Generation of Surgeons: Making It Stick, Making It Real, Making It Together,” will take place at the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) Institute of Simulation in Healthcare (WISH) at the University of Washington (UW), Seattle. The ultimate goal of the forum will be to begin formulating principles and standards that will maximize the value of simulation and ultimately improve surgeon performance.

Hosting the forum are David B. Hoyt, MD, FACS, ACS Executive Director; Ajit K. Sachdeva, MD, FACS, FRCSC, Director, ACS Division of Education; Robert Sweet, MD, FACS, professor of urology, UW, medical director, UW Medicine Kidney Stone Center at Northwest Hospital, and executive director, WISH and Center for Research in Education and Simulation Technologies, UW Medicine; and Carlos A. Pellegrini, MD, FACS, chief medical officer, UW Medicine, vice-president for medical affairs, UW, and Past-President of the ACS.

The forum will include opening remarks from ACS and UW leadership and panel sessions on key topics, including model simulation programs, advances in simulation technologies and tools, and best practices for broadly applying simulation training and assessment. A keynote address centered on the cognitive learning process behind skills acquisition and expert performance, WISH simulation lab tours, and a workshop session on team training will round out the program. To learn more about the forum and to register, visit the ACS-AEI event page at www.facs.org/education/accreditation/aei/next-generation.

The American College of Surgeons Accredited Education Institutes (ACS-AEI) will host a forum June 12 that seeks to mobilize stakeholders to identify best practices and key considerations in simulation training and to build the case for more standardized implementation of simulation training and assessment in early-career surgical education. The forum, called “Training the Next Generation of Surgeons: Making It Stick, Making It Real, Making It Together,” will take place at the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) Institute of Simulation in Healthcare (WISH) at the University of Washington (UW), Seattle. The ultimate goal of the forum will be to begin formulating principles and standards that will maximize the value of simulation and ultimately improve surgeon performance.

Hosting the forum are David B. Hoyt, MD, FACS, ACS Executive Director; Ajit K. Sachdeva, MD, FACS, FRCSC, Director, ACS Division of Education; Robert Sweet, MD, FACS, professor of urology, UW, medical director, UW Medicine Kidney Stone Center at Northwest Hospital, and executive director, WISH and Center for Research in Education and Simulation Technologies, UW Medicine; and Carlos A. Pellegrini, MD, FACS, chief medical officer, UW Medicine, vice-president for medical affairs, UW, and Past-President of the ACS.

The forum will include opening remarks from ACS and UW leadership and panel sessions on key topics, including model simulation programs, advances in simulation technologies and tools, and best practices for broadly applying simulation training and assessment. A keynote address centered on the cognitive learning process behind skills acquisition and expert performance, WISH simulation lab tours, and a workshop session on team training will round out the program. To learn more about the forum and to register, visit the ACS-AEI event page at www.facs.org/education/accreditation/aei/next-generation.

The American College of Surgeons Accredited Education Institutes (ACS-AEI) will host a forum June 12 that seeks to mobilize stakeholders to identify best practices and key considerations in simulation training and to build the case for more standardized implementation of simulation training and assessment in early-career surgical education. The forum, called “Training the Next Generation of Surgeons: Making It Stick, Making It Real, Making It Together,” will take place at the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) Institute of Simulation in Healthcare (WISH) at the University of Washington (UW), Seattle. The ultimate goal of the forum will be to begin formulating principles and standards that will maximize the value of simulation and ultimately improve surgeon performance.

Hosting the forum are David B. Hoyt, MD, FACS, ACS Executive Director; Ajit K. Sachdeva, MD, FACS, FRCSC, Director, ACS Division of Education; Robert Sweet, MD, FACS, professor of urology, UW, medical director, UW Medicine Kidney Stone Center at Northwest Hospital, and executive director, WISH and Center for Research in Education and Simulation Technologies, UW Medicine; and Carlos A. Pellegrini, MD, FACS, chief medical officer, UW Medicine, vice-president for medical affairs, UW, and Past-President of the ACS.

The forum will include opening remarks from ACS and UW leadership and panel sessions on key topics, including model simulation programs, advances in simulation technologies and tools, and best practices for broadly applying simulation training and assessment. A keynote address centered on the cognitive learning process behind skills acquisition and expert performance, WISH simulation lab tours, and a workshop session on team training will round out the program. To learn more about the forum and to register, visit the ACS-AEI event page at www.facs.org/education/accreditation/aei/next-generation.

The American College of Surgeons (ACS) Evidence-Based Decisions in Surgery (EBDS) and Patient Education programs have collaborated to offer established surgical practice guidelines that surgeons can use at the point of care. The modules, which are viewable on all digital platforms, now include relevant patient education information to aid in high-quality care for surgical patients.

The EBDS modules provide peer-reviewed recommendations for surgeons based on clinical practice guidelines promulgated by national and international professional organizations and government agencies. The surgical recommendations are presented along with the strength of the evidence that supports the recommendations. Grading of the evidence is done with the understanding that the contribution of surgical judgment in developing effective and safe treatment strategies is essential for effective care of individual surgical patients. As such, the modules are intended to guide surgical practice but should always take into consideration the needs and preferences of individual patients.

Each EBDS module has a section labeled “Suggested Talking Points for Patient Education,” which covers topics such as who developed the guidelines, recommended actions for patients and physicians, and potential benefits and harms associated with these recommendations. Where applicable, links will now be included in the modules that will lead the user directly to the patient education material that supports the particular topic. For example, the EBDS module for Hemodialysis Access has a link to the Patient Education section of the Central Lines Home Skills Kit. The home page for the Central Lines Home Skills Kit provides a host of information, ranging from a welcome video, to a Central Lines Home Skills booklet, to an evaluation.

At present, 13 EBDS modules have links to patient education material from the ACS. As more modules and patient education materials are developed, more comprehensive offerings will be available to surgeon members. Brochures for patients provide all pre-, peri-, and postoperative information to help patients make informed decisions and fully participate in all aspects of their care for many common surgical procedures. The Home Skills Kit series uses a multimedia approach to explain, demonstrate, and provide directed learning experiences and practice opportunities for patients requiring a lung procedure, an ostomy, feeding tube, central line placement, or complex wound care.

ACS Patient Education resources are based on contemporary principles of evidence-based medicine tailored to the individual patient’s needs, with a focus on health literacy. Patients who are trained to actively participate in their care show improved treatment compliance, decreased complications, and enhanced outcomes and satisfaction.*

With outpatient operations representing a growing share (65 percent, 17.3 million) of all procedures performed in the U.S., patient preparation is essential to the delivery of high-value, safe surgical care.

To learn more and view the modules, go to ebds.facs.org. After logging in with ACS credentials, click on the Topics tab and take note of the modules with a tag labeled “Updated” to find modules that have ACS Patient Education information included. This can be found in the Suggested Talking Points for Patient Education section with links directly to the content available.

Ms. Dalal is Senior Manager, Evidence-Based Decisions in Surgery, ACS Division of Education, Chicago, IL.

Ms. Strand is Manager, ACS Patient Education Program, Division of Education.

The American College of Surgeons (ACS) Evidence-Based Decisions in Surgery (EBDS) and Patient Education programs have collaborated to offer established surgical practice guidelines that surgeons can use at the point of care. The modules, which are viewable on all digital platforms, now include relevant patient education information to aid in high-quality care for surgical patients.

The EBDS modules provide peer-reviewed recommendations for surgeons based on clinical practice guidelines promulgated by national and international professional organizations and government agencies. The surgical recommendations are presented along with the strength of the evidence that supports the recommendations. Grading of the evidence is done with the understanding that the contribution of surgical judgment in developing effective and safe treatment strategies is essential for effective care of individual surgical patients. As such, the modules are intended to guide surgical practice but should always take into consideration the needs and preferences of individual patients.

Each EBDS module has a section labeled “Suggested Talking Points for Patient Education,” which covers topics such as who developed the guidelines, recommended actions for patients and physicians, and potential benefits and harms associated with these recommendations. Where applicable, links will now be included in the modules that will lead the user directly to the patient education material that supports the particular topic. For example, the EBDS module for Hemodialysis Access has a link to the Patient Education section of the Central Lines Home Skills Kit. The home page for the Central Lines Home Skills Kit provides a host of information, ranging from a welcome video, to a Central Lines Home Skills booklet, to an evaluation.

At present, 13 EBDS modules have links to patient education material from the ACS. As more modules and patient education materials are developed, more comprehensive offerings will be available to surgeon members. Brochures for patients provide all pre-, peri-, and postoperative information to help patients make informed decisions and fully participate in all aspects of their care for many common surgical procedures. The Home Skills Kit series uses a multimedia approach to explain, demonstrate, and provide directed learning experiences and practice opportunities for patients requiring a lung procedure, an ostomy, feeding tube, central line placement, or complex wound care.

ACS Patient Education resources are based on contemporary principles of evidence-based medicine tailored to the individual patient’s needs, with a focus on health literacy. Patients who are trained to actively participate in their care show improved treatment compliance, decreased complications, and enhanced outcomes and satisfaction.*

With outpatient operations representing a growing share (65 percent, 17.3 million) of all procedures performed in the U.S., patient preparation is essential to the delivery of high-value, safe surgical care.

To learn more and view the modules, go to ebds.facs.org. After logging in with ACS credentials, click on the Topics tab and take note of the modules with a tag labeled “Updated” to find modules that have ACS Patient Education information included. This can be found in the Suggested Talking Points for Patient Education section with links directly to the content available.

Ms. Dalal is Senior Manager, Evidence-Based Decisions in Surgery, ACS Division of Education, Chicago, IL.

Ms. Strand is Manager, ACS Patient Education Program, Division of Education.

The American College of Surgeons (ACS) Evidence-Based Decisions in Surgery (EBDS) and Patient Education programs have collaborated to offer established surgical practice guidelines that surgeons can use at the point of care. The modules, which are viewable on all digital platforms, now include relevant patient education information to aid in high-quality care for surgical patients.

The EBDS modules provide peer-reviewed recommendations for surgeons based on clinical practice guidelines promulgated by national and international professional organizations and government agencies. The surgical recommendations are presented along with the strength of the evidence that supports the recommendations. Grading of the evidence is done with the understanding that the contribution of surgical judgment in developing effective and safe treatment strategies is essential for effective care of individual surgical patients. As such, the modules are intended to guide surgical practice but should always take into consideration the needs and preferences of individual patients.

Each EBDS module has a section labeled “Suggested Talking Points for Patient Education,” which covers topics such as who developed the guidelines, recommended actions for patients and physicians, and potential benefits and harms associated with these recommendations. Where applicable, links will now be included in the modules that will lead the user directly to the patient education material that supports the particular topic. For example, the EBDS module for Hemodialysis Access has a link to the Patient Education section of the Central Lines Home Skills Kit. The home page for the Central Lines Home Skills Kit provides a host of information, ranging from a welcome video, to a Central Lines Home Skills booklet, to an evaluation.

At present, 13 EBDS modules have links to patient education material from the ACS. As more modules and patient education materials are developed, more comprehensive offerings will be available to surgeon members. Brochures for patients provide all pre-, peri-, and postoperative information to help patients make informed decisions and fully participate in all aspects of their care for many common surgical procedures. The Home Skills Kit series uses a multimedia approach to explain, demonstrate, and provide directed learning experiences and practice opportunities for patients requiring a lung procedure, an ostomy, feeding tube, central line placement, or complex wound care.

ACS Patient Education resources are based on contemporary principles of evidence-based medicine tailored to the individual patient’s needs, with a focus on health literacy. Patients who are trained to actively participate in their care show improved treatment compliance, decreased complications, and enhanced outcomes and satisfaction.*

With outpatient operations representing a growing share (65 percent, 17.3 million) of all procedures performed in the U.S., patient preparation is essential to the delivery of high-value, safe surgical care.

To learn more and view the modules, go to ebds.facs.org. After logging in with ACS credentials, click on the Topics tab and take note of the modules with a tag labeled “Updated” to find modules that have ACS Patient Education information included. This can be found in the Suggested Talking Points for Patient Education section with links directly to the content available.

Ms. Dalal is Senior Manager, Evidence-Based Decisions in Surgery, ACS Division of Education, Chicago, IL.

Ms. Strand is Manager, ACS Patient Education Program, Division of Education.