Surgical Superstition: Defending the Indefensible

Tuesday, May 13, 2025

9:00 AM – 9:45 AM PT

Location: Ballroom 6A, Upper Level

Co-Moderator(s)

Kyle Cologne, MD

Professor of Surgery
Keck School of Medicine of the University of Southern California
Keck School of Medicine of the University of Southern California
Los Angeles, California, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
Dana Hayden, MD, MPH

Professor
University of Wisconsin-Madison
University of Wisconsin-Madison
Madison, WI, US

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Learning Objectives:

Upon completion of this activity, participants should be able to:

Explain aspects of perioperative care with good, bad, and non-existent supporting evidence to support their ongoing use in clinical practice.
Recognize perioperative clinical practice bundle items that despite a lack of high quality evidence still may have benefit.
Describe perioperative clinical practice bundle elements that are done based on personal preference and have no evidence positive or negative to sway use.

CME Credit: 0.75
Contact Hours: 0.75

As surgical practice becomes more evidence-based, what features of our practice do we continue to employ despite a lack of data? This will be a look at both the good and the bad in that regard, as some things are too difficult to study scientifically, while others have been debunked.

Will also include Q&A and polling to better allow some of these issues to be hashed out. What has solid evidence, what is pseudo-science, and what is completely made up? Come to this session to find out!

Presentations:

9:00 AM – 9:05 AM PT

Introduction
9:05 AM – 9:11 AM PT

Anastomotic Techniques that are Minimally Supported By the Data –crotch stitches, fibrin glue, overlapping staple lines, drains, ICG, trials to avoid diverting ileostomy (future?), Sending anastomotic donuts for pathology, rigid procto vs. flex sig for anastomosis eval etc.
Faculty: Ana De Roo, MD – University of Wisconsin-Madison
9:12 AM – 9:18 AM PT

Postoperative Enhanced Recovery/ Ileus-avoidance Practices which are Minimally Supported By Data -- (Gum chewing, carbohydrate loading, NG clamp/gravity trials, low fiber diet, CLD to prevent aspiration, wrapping stomas in seprafilm)
Faculty: Robert Nunoo, MD – WakeMed Health and Hospital
9:19 AM – 9:25 AM PT

Peri-operative Practices which are Minimally Supported by Data (NPO times > 2 hrs, preop drinks, lifting restrictions after surgery, Stopping DVT prophylaxis for any bleeding?, running vs. interrupted fascial closure sutures)
Faculty: Alexis Grucela, MD (she/her/hers) – Northern Westchester Hospital, Northwell Health
9:26 AM – 9:32 AM PT

SSI Stuff: Bowel Prep Practices, Antibiotic Sutures, antibiotic irrigation washouts, nasal swabs / decontamination for MRSA, Probiotics, postop antibiotic duration (if spillage), irrigating wound protectors, betadine to stapler before use / to incision
Faculty: Wissam J. Halabi, MD (she/her/hers) – Enloe Health
9:33 AM – 9:45 AM PT

Question and Answer