Dr. Joshua Sterling

Kind of washing out that pocket with the RSF instead of antibiotics.

It's not going to create any sort of inflammatory reaction that you're worried about with the tissue while making sure that any bacteria that are there do get eliminated.

And then I've also always wanted to do using some sort of irrigation as the wet to dry dressing instead of just saline for it.

Yeah.

That's kind of the other thing that I was thinking of, you know, for those patients, what, you know, what can we do to minimize their bacterial load and, you know, hopefully preserve some of the tissue that's there so that when you go back to try to close them, it's a little easier to do.

I haven't quite gotten through to some of my emergency general surgery colleagues that, you know, less is more, that you can always go back and cut more tissue, but once it's gone, it's gone.

know i the way i think about it just kind of like your capital and your reserve and so you know i think that if we are better antibiotic stewards everywhere we there can be a couple of disease processes or instances where like you know what now let's we're going to throw everything out this you know maybe it's a little overkill but in this situation it's not and you know so if we kind of zoom out and think of like all the times that we we aren't using antibiotics where we're trying to decrease that antibiotic resistance it's so that you know in the cases where

It definitely can help a patient, you know, get back to their baseline sooner.

We can use it for that.

Yeah, no, you're keeping your powder dry to use it when you need it as opposed to just kind of using it every day.

I think it's really hard to unlearn things.

There have been several survey studies out of the GERS committee kind of looking at what people do and, you know, how close it is to guidelines and recommendations.

And across the board, if you want to, pretty close to, if you want to know what somebody does, look at where they trained and that's probably what they're still going to do.

It's like we talked about at the beginning.

We know what the worst case scenario is, and we might not ever see the downside of doing it.

But I think it does take a unified effort to try to get those in, you know, to think about it and do it in a safe way where we are thinking about more than, you know, just a culture and trying to kind of drill down to know what bacteria should we be worried about, what bacteria shouldn't we be worried about?

Is there kind of a mix or a threshold?

to do it.

I think, you know, hopefully this could be one of the things that AI and kind of large language models and kind of those model based studies can help with, you know, where we can kind of know how bacteria or genes are going to change and see that.

So, you know, hopefully