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Did you know CCS is the only ERAS® Society Certified Center in the Triad?

ERAS® is short for Enhanced Recovery After Surgery.  This worldwide society sets guidelines for the best care for several surgical operations.  These guidelines help shorten surgery recovery times by 30% or more and decrease complications.

At Central Carolina Surgery, PA, we have been certified as an ERAS® center. We are the only ERAS® society certified center in the Triad.  Our goal at Central Carolina Surgery is to enhance the post-operative course for our patients while minimizing opioid use. 

When visiting with your surgeon be sure to ask about our ERAS® protocols and how it will help you in your recovery.

To learn more about ERAS® visit http://erassociety.org/

CCS 20 year History and Accomplishments

On October 1, 1999,  Central Carolina Surgery, P.A. was created as an independent general surgery group as a merger between Triad Surgical Specialists and Greensboro Surgical Associates. Our primary goal was to continuously improve the care and experience of our patients.     We achieved this goal by consolidating general surgery services and creating efficiencies through collaboration, subspecialization, growth, education and a positive professional culture in the region.  

      We have been successful in this endeavor. Central Carolina Surgery, P.A. is now recognized as one of the top-performing general surgery groups in the state of North Carolina in terms of safety and outcomes. Our surgeons are broadly trained and experienced in the art and science of surgery. We continue to recruit the best fellowship-trained surgical professionals to our practice.   Through our initiatives, we have created subspecialty divisions with robust activity in general surgery, surgical oncology, hepatobiliary surgery, benign and malignant breast disease, bariatric surgery, trauma surgery, endocrine surgery, colorectal surgery, minimally invasive and robotic surgery, a dedicated inpatient acute care surgery service. Our group is also actively engaged in teaching clinical skills  to other professionals.

     Our practice has reached out and strengthened our corporate and cultural relationship with Cone Health, Randolph Health, and with referring providers.   We now provide inpatient and outpatient surgical services in Guilford, Rockingham, Alamance and Randolph Counties. Our physicians serve in diverse leadership positions within Cone Health, aligning our professional and cultural strategy.

      Continued growth and excellence in all of our activities is a fundamental part of our strategic plan.  Central Carolina Surgery is well-positioned for the future and will be privileged to serve our region for many years.

Mesh Information for Patients – Frequently Asked Questions (FAQs) :

Q: What is mesh?

A: Mesh is a sheet of material used to reinforce a hernia repair.  There are many different kinds.  Some stay in the body forever, some are slowly absorbed, and some are made of biologic materials.  Your Surgeon will discuss what they believe to be the most appropriate mesh for you.

 

Q: Why is mesh used?

A: Hernias happen when weak spots become holes in your abdominal wall.  When surgeons fix those holes, they use mesh to reinforce their repair.  Mesh helps keep hernias from coming back.  Hundreds of studies have demonstrated that mesh can be used safely to prevent a hernia from coming back.

  • Groin Hernia: 54% less likely with mesh compared with a non-mesh operation1
  • Umbilical Hernia: 69% less likely with mesh compared with a non-mesh operation2
  • Ventral Hernia: 73% less likely with mesh compared with a non-mesh operation3

 

Q: What happens if my surgeon does not use mesh?

A: Your surgeon may be able to repair your hernia without mesh.  As above, the hernia may be more likely to come back.  How likely depends on where and how big the hernia is.

 

Q: If you repair my hernia with mesh, what is the expected risk/benefit?

A: As shown above, mesh may help prevent the hernia from returning.  Risks of using mesh include mesh infection, mesh migration, and excessive mesh shrinkage.  These risks are possible but occur at low frequency.

 

Q: Can mesh become infected?  What happens then?

A: With the right mesh in the right patient, the likelihood of mesh becoming infected is very low.  If an infection happens, it can require antibiotics and sometimes surgery.

 

Q: Does mesh cause pain?

A: Some patients have pain after hernia surgery with mesh, but pain can also develop after hernia surgery without mesh.  Recent studies found equal numbers of patients with pain, with and without mesh.2,4  Indeed, in most operations the use of mesh results in an improvement in quality of life.

 

Q: What are the mesh lawsuit commercials about?

A: Some mesh products have been used incorrectly or withdrawn from the market due to complications. Many of these were not used for hernia procedures.  Not all meshes are the same.  The surgeon will make choices concerning the right mesh based on the current information available.

 

Q: Will the mesh show up or interfere with imaging tests such as X-rays, MRIs, CT scans?

A: Depending on what mesh is used, it may show up on imaging studies.  This can be helpful for your surgeon in the follow up.  Mesh will not prevent you from getting X-rays, MRIs, or CT scans.

 

Resources for Patients:

USA Food and Drug Administration:

https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/HerniaSurgicalMesh/default.htm

Americas Hernia Society: https://americanherniasociety.org/patient-education/

British Hernia Society:  http://www.britishherniasociety.org/for-patients/

 

References:

1.      Lockhart K, Dunn D, Teo S, et al. Mesh versus non-mesh for inguinal and femoral hernia repair.

Cochrane Database Syst Rev. September 2018. doi:10.1002/14651858.CD011517pub2

2.      Kaufmann R, Halm JA, Eker HH, et al. Mesh versus suture repair of umbilical hernia in adults: a randomized, double-blind, controlled, multicentre trial. Lancet. 2018;391(10123):860-869. doi:10.1016/S0140-6736(18)30298-8

3.      Mathes T, Walgenbach M, Siegel R. Suture Versus Mesh Repair in Primary and Incisional Ventral Hernias: A Systematic Review and Meta-Analysis. World J Surg. 2015. doi:10.1007/s00268-015-3311-2

4.      Overg S, Andresen K, Klausen TW, Rosenberg J. Chronic pain after mesh versus nonmesh repair of inguinal hernias: A systematic review and a network meta-analysis of randomized controlled trails.  Surg (United States). 2018;163(5):1151-1159. doi:10.1016/j.surg.2017.12.017

 

Other questions you should ask your surgeon about surgical mesh for hernia repair include:

  • What is the mesh you will be using made of?
  • What is the name of the mesh you will be using?
  • In my case, is it possible to repair the hernia without mesh and if so, what is the expected risk/benefit?
  • Is there patient information that comes with the mesh product and if so, how can I obtain it?
  • What is the risk for hernia recurrence? Pain? Infection? Other complications?  Do these risks change depending on the type of mesh that you use?
  • How does the operative approach you are recommending (e.g. open repair versus laparoscopic repair) affect how the mesh will be used?
  • In the future if I require a repeat operation, what information should I tell my health care providers regarding the mesh that was used and where it was placed?
  • What is your rate of hernia recurrence with patients like me?  With mesh, without mesh?

What is Breast Pain?

By Matthew Wakefield, MD

Breast pain, or mastalgia, is very common.  It is usually cyclic mastalgia.  This is pain and tenderness in both breasts before your menstrual cycle.  Breast tissue can also feel swollen or lumpy during that time.  Most commonly breast pain occurs in the upper outer portion of your breast towards your underarm.  Cyclical breast pain usually resolves after your menstrual cycle. 

Cyclical mastalgia is most common in 30s and 40s.  It can occur earlier and can occur after menopause.  This is especially true if taking hormone replacement therapy when postmenopausal.  This type of breast pain is almost never associated with breast cancer.

 

When should you see a doctor?

Breast pain that needs to be seen by your physician is pain that is not cyclical.  This pain does not occur regularly with menstrual cycle.  Pain that occurs in a specific spot in the breast also needs to be seen by your doctor.  You will need a breast exam and possibly further evaluation. 

 

What is the treatment for breast pain?

Dietary changes:

1.      Sometimes eliminating caffeine from your diet may help breast tenderness.  This may take up to six months to have relief.  Caffeine is in many things we eat and drink so must pay attention.

2.      Eliminating chocolate may have same effect as caffeine.

3.      Eating a low-fat diet can decrease estrogen levels and reduce breast pain as well as help general health.  Limiting meat and dairy products and eating more fish can be helpful.

4.      It is helpful to keep a food log to associate certain foods with breast pain also.

Lifestyle changes:

1.       Exercise can decrease estrogen levels, help with general fitness and weight and improve breast pain and tenderness.

2.      Stop smoking

3.      Make sure you have well-fitting, supportive bra

4.      Warm compresses when tenderness and pain occur

Nutritional supplements:

1.      Evening primrose oil may help reduce breast pain.  Recommend taking 3 grams per day for at least six months to see benefits. 

2.      Dietary flaxseed may reduce breast pain in some studies. (1 muffin with 25 mg)

3.      Vitamin E (200-600IU/day) and Vitamin B6 may be helpful also.  It is reasonable to try these for several months to see if they help. 

Medications:

1.       Nonsteroidal over the counter pain medications like ibuprofen are also helpful.  Sometimes a topical gel like diclofenac might be helpful also.

2.      Tamoxifen is an anti-hormonal medication used for breast cancer treatment and prevention.  For severe cases it can be used for breast tenderness but due to side effects and risks it is used sparingly.

3.      Other medications like danazol and bromocriptine have been used in past but due to significant side effects they are really not used anymore.

Thanks to Hidden Scar™ Surgery, Breast Cancer’s Visible Reminders are Minimized for Many Women in Greensboro, NC

Thanks to Hidden Scar™ Surgery, Breast Cancer’s Visible Reminders are Minimized for Many Women in Greensboro, NC

If you don’t already know someone that’s been diagnosed with breast cancer, the chances are good that you will. In 2018 alone, 330,000 American women will encounter some form of breast cancer. According to breastcancer.org, research shows that around 12.4% of women will develop invasive breast cancer in their lifetime.

Hidden Scar™ Breast Cancer Surgery helps diminish visible reminders of breast cancer for many women.

Central Carolina Surgery of Greensboro, North Carolina staffs the most certified Hidden Scar™ Breast Cancer surgeons in the state and perhaps the entire country.

“Nine of our surgeons have undergone Hidden Scar™ Certification. There are so many surgical options for breast cancer patients today. For many women nipple-sparing mastectomy and lumpectomy, as well as other breast-conserving procedures make the visible signs of breast cancer minimal,” says Dr. Matt Wakefield, a surgeon with Central Carolina Surgery.

 

Find it. Treat it. Beat it. Thrive!

 

Awareness has made breast cancer treatment and survival very successful. According to the National Cancer Institute’s SEER database from 2007 – 2013, the 5-year relative survival rate for women with stage 0 or stage I breast cancer is close to 100%. Stage II patients experience 93%. Even those diagnosed at stage III are tracked with a 72% 5-year relative survival rate.

 

“Breast cancer advances have made it possible for us to offer a multitude of surgical options, including options that prioritize cosmetic outcomes. The research has found that 53% of lumpectomy patients and 33% of mastectomy patients don’t feel completely informed about their surgical options,” says Dr. Faera L. Byerly, MD, FACS.

 

For many women, scars matter.

Studies show that breast surgery scars significantly impact a woman’s psychological and emotional recovery and quality of life after surgery because scars can have a tremendous impact on a woman’s self-confidence, intimacy, and body image.

Central Carolina Surgery is on a mission to offer breast cancer patients in the greater Greensboro area every proven surgical option and to make them fully aware of those options as part of Breast Cancer Awareness Month.

Hidden Scar™ Breast Cancer Surgery is an advanced approach to removing breast cancer.

Today, surgeons in Greensboro, North Carolina can surgically remove breast cancer with a mastectomy procedure (remove all of your breast tissue) or a lumpectomy procedure (remove only part of your breast tissue) with little to no visible reminder of the surgery or your cancer.

“What we’ve learned to do is place that incision in a location that is hard to see. So, when it heals, you can’t see the scar. Ladies don’t have to experience a visible reminder of the surgery or cancer,” says Dr. Wakefield.

What are Hidden Scar™ Procedures and Who’s Eligible?

Hidden Scar™ Breast Cancer Surgery qualification is based on the size and location of the tumor as well as breast shape and breast size.

The Hidden Scar™ approach can be performed for a mastectomy or a lumpectomy procedure. Fortunately, these techniques do not have a higher risk of cancer recurrence than any other type of technique.

A Nipple Sparing Mastectomy can be performed as a Hidden Scar™ Procedure, which means that the incision is made in a place that is hard to see such as the natural crease beneath the breast known as the “inframammary fold” or in some cases the surgeon removes all of the breast tissue but does not remove the nipple.

Call us for a consultation at (336) 387-8100 to learn more or see our website under breast surgery. Click here to read more and see a short video on how it all works.

Do you know someone about to have breast cancer surgery? Check out the many benefits of Radioactive Seed Localization by watching the video below. Greensboro, North Carolina is only one of two locations throughout the state certified in this life-changing procedure.

Breast Cancer Surgery

 

Why should I have a Colonoscopy?

Colorectal cancer (colon or rectal cancer) is the 2nd leading cause of death in the US today.  Do know someone who has been affected by colorectal cancer?  Most colorectal cancer is completely random in whom it affects with only a small percentage inherited (passed down from related family members).    The good news is that it’s mostly preventable with the right screening tests.  People between the ages of 50-75 are at the highest risk for getting this disease. Continue reading “Why should I have a Colonoscopy?”

Central Carolina Surgery Delivers Comprehensive Breast Cancer Care

Experience Matters

Most women have heard the statistic that for every 8 women in the U.S., 1 will be diagnosed with breast cancer during her lifetime.  At Central Carolina Surgery, we understand that the being diagnosed with breast cancer can bring tremendous stress, anxiety and confusion. We believe that providing the best treatment possible includes helping patients and their families navigate through the multitude of decisions during a very difficult time.  We evaluate and treat over 600 breast cancer cases per year. Continue reading “Central Carolina Surgery Delivers Comprehensive Breast Cancer Care”