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(L to R): Honoree Thomas Sculco, M.D., surgeon-in-chief emeritus at HSS, with host Maria Bartiromo, Fox Business Network anchor and global markets editor, and Mario Gabelli, an underwriter of the event. / Courtesy of Don Pollard

Lifetime Achievement Award for Sculco; Gun Shot Infections; Best Healthcare Work Places

Elizabeth Hofheinz, M.P.H., M.Ed. • Mon, June 12th, 2017

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Thomas P. Sculco, M.D. Receives Lifetime Achievement Award

Thomas P. Sculco, M.D., surgeon-in-chief emeritus at Hospital for Special Surgery (HSS), has been presented with the Lifetime Achievement Award at HSS’ 34th Annual Tribute Dinner. The event was held on June 5, 2017 at the American Museum of Natural History in New York City. Maria Bartiromo, anchor and global markets editor at Fox Business News, hosted the black tie event, with Mario J. Gabelli, chief investment officer of Gabelli Funds, as an underwriter.

Dr. Sculco told OTW, “This is the culmination of my almost 40 year career at Hospital for Special Surgery. HSS has been a key part of my life and the relationships with patients, faculty and staff of this great hospital are very special to me. To watch HSS grow from a small specialty hospital to a major global orthopedic center has been exciting and to be part of this development has been an incredible experience. I am humbled to receive this award and do so on behalf of all the great individuals I have worked with and who make HSS what it is today.”

Dr. Sculco earned his medical degree at Columbia University and completed his residency at HSS. He served as HSS surgeon-in-chief from 2003 through 2014.

"Dr. Sculco is a pioneer of less invasive surgical techniques including the design of instruments," said Todd Albert, M.D., surgeon-in-chief at HSS, in the June 1, 2017 news release. "He has dedicated his career to providing superior patient outcomes in hip and knee replacement and we are honored to call him one of our own."

Dr. Sculco has been awarded the Otto Aufranc and Charnley Award from the Hip Society, as well as the Arthritis Foundation's Lifetime Achievement Award. In 2005 he received the Gold Medal Award for Clinical Medicine from Columbia University College of Physicians and Surgeons and in 2013 he was awarded the Austrian Cross of Honor, First Class, for Science and Art.

Dr. Sculco recently founded the Complex Joint Reconstruction Center (CJRC). The center provides diagnosis and treatment for the most challenging cases in joint reconstruction and conducts research on implant failure.

Asked for details on this new center, Dr. Sculco commented to OTW, “The CJRC provides expert diagnosis and treatment for the most challenging joint reconstructions and conducts leading research on the causes and prevention of implant failure. The Center will serve as a single point of access to medical care for these patients who are often referred to HSS from around the world due to the complexity of their cases. The CJRC has already created a new registry that will capture patient data, genetic profiles and store tissue samples serving as a foundation for clinical trials, translational research and innovations in treatment. Additionally, case reviews are offered by the CJRC.”

Infection Rare in Low-Velocity Extremity Gunshot Injuries

A new retrospective review of 140 patients at a Level 1 trauma center has examined the infection rates in low-energy gunshot wounds to the extremities with the aim toward establishing a standard of care.

Heather Vallier, M.D. is an orthopedic trauma surgeon at MetroHealth Medical Center in Cleveland, Ohio. She commented to OTW, “Our level 1 trauma center has seen a large rise in gunshot injuries over the past several years. Nearly all of these are low velocity handguns. Variations in management have been noted among providers within our orthopedic department and among our colleagues in other specialties, including the emergency department, and general trauma surgeons. We had no consistent treatment recommendations regarding need for antibiotics, type and duration of antibiotics when given, and need for surgical debridement of the gunshot wound itself, when no other surgical indication is present.”

“Our research team performed a survey of OTA members (presented at the OTA Annual Meeting in 2016) showing no agreement for treatment recommendations on several proposed gunshot scenarios. Over half of the respondents favored giving extended courses of antibiotics for low energy gunshot wounds causing only soft tissue injury or nonoperative fracture.”

“As no good studies exist to define a standard of care for these injuries, we performed a review of our registry for a 5-year period, identifying over 950 patients with gunshot injuries to the pelvis and/or extremities. Our purpose was to demonstrate the spectrum of treatment strategies, to identify patients at risk for infection and/or readmission, and to develop recommendations for treatment for low energy gunshot injuries with or without fracture.”

“We found that deep infections are rare after low energy gunshot (3.6%) and no deep infections occurred after nonoperative fracture. Patients with vascular injury requiring repair are at high risk for infection.”

“We also found that intraarticular gunshots do not require arthrotomy and debridement (unless a large retained piece of bullet is in the joint).”

“Patients with soft tissue injury only or with nonoperative fracture may be safely treated with a single dose of IV antibiotics in the emergency department and then sent home with local wound care and no oral antibiotics (we found that additional antibiotics did not decrease the infection rate).”

“Intraarticular gunshots do not require surgical arthrotomy and debridement. We believe that these measures alone will reduce unnecessary antibiotics and unnecessary surgeries—reducing risks and expenses. This is now the protocol in our hospital.”

HOI Named One of Best Healthcare Places to Work

It’s nice to go to work in Southern California—especially if you work at Hoag Orthopedic Institute (HOI), based in Orange County. HOI has just been named a Modern Healthcare ‘Best Places to Work in Healthcare’ for 2017. With this honor, HOI is officially now the only hospital in Southern California to receive the distinction two years in a row.

“Hoag Orthopedic Institute is honored to be included in this year’s prestigious ‘Best Places to Work in Healthcare’ list,” said Dr. Carlos A. Prietto, president and interim CEO of Hoag Orthopedic Institute, in the May 31, 2017 news release. “Our staff is truly remarkable and should be celebrated for the instrumental role they’ve played in establishing our culture as one that epitomizes patient-centric care and service.”

Modern Healthcare’s 2017 ‘Best Places to Work in Healthcare’ list was announced in May 2017 with a ranked order to be announced in late September. The list will also be prominently featured in a special supplement of the magazine in the October 2 issue.

“More Californians choose Hoag Orthopedic Institute for joint replacement than any other hospital in the state,” added Robert Gorab, M.D. chief medical officer of Hoag Orthopedic Institute. “It’s great to learn that our staff enjoy the HOI experience as much as our patients do.”

Asked how they go about selecting staff, Dr. Gorab commented to OTW, “When we interview people we ask them to tell us a story about a patient they have cared for. The story they choose to tell is indicative of their level of empathy, compassion, and ‘patient-centeredness.’ There is a culture of teamwork and multidisciplinary collaboration at the Hoag Orthopedic Institute. We ask questions about previous experiences working as a team to assess attitudes and cultural fit.”

“HOI was built on innovation and evolution, requiring flexibility and a positive attitude toward change. Employees are proud to be part of that change. When we are interviewing we assess the response to these concepts, looking for enthusiasm and a sparkle in the eye of prospective candidates. Some individuals do not like change, and they would be better off in another organization.”

“We have traditional methods of training such as conferences, online modules, and classes, but the real training comes from orienting with an HOI team member, and interacting with and working alongside the HOI team. The culture is contagious.”

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