I am assigned the role of moderator in a Panel discussion on “Use of Phasix mesh in surgery” where there will be five renowned professors as panelists. It is of 40-45 minutes. I want to design this with real time clinical scenarios depicting every aspects of bioresorbable mesh its indications contraindications, interesting cases and very interactive. Draft me a script of me as the moderator

Searching the Web

Phasix mesh bioresorbable P4HB indications contraindications clinical outcomes 2024 2025

Searching PubMed

Phasix mesh P4HB bioresorbable hernia repair outcomes

Searching the Web

Phasix mesh surgical technique complications real world cases contaminated field hernia

Here is your complete moderator script, built around real clinical scenarios, timed for 40-45 minutes, and structured to keep all five panelists engaged and the audience energized.

PANEL DISCUSSION MODERATOR SCRIPT

"Use of Phasix Mesh in Surgery"

Duration: 40-45 Minutes | Format: 5 Panelists + Moderator

[FORMAT LEGEND]

[MOD] = Your lines as Moderator

[SCENARIO] = Clinical case slide/display cue

[DIRECT] = Directed question to a specific panelist

[OPEN] = Open question to all panelists

[AUDIENCE] = Audience interaction cue

(italics) = Stage direction / timing note

PRE-SESSION SETUP NOTES

Panelist Roles (assign based on expertise before the session):
- Panelist A - Colorectal/Hernia Surgeon (Contaminated field expert)
- Panelist B - Plastic & Reconstructive Surgeon (AWR / Component separation)
- Panelist C - General & Laparoscopic Surgeon (Minimally invasive techniques)
- Panelist D - Critical Care/Comorbidity Specialist or Bariatric Surgeon (High-risk patient profile)
- Panelist E - Senior Surgeon / Evidence & Guidelines Expert
Prepare a slide with each clinical scenario as a visual case card
Keep a timer visible to yourself - aim for ~8 min per segment

SEGMENT 1: OPENING & SCENE-SETTING

(Minutes 0-4)

[MOD]

Good [morning/afternoon], everyone. Welcome to what I think will be one of the most clinically grounded sessions of this conference. I am [Your Name], and I have the privilege of moderating this panel discussion on a topic that sits right at the intersection of biology, innovation, and surgical decision-making - the use of Phasix mesh in surgery.

Before I introduce our panelists, let me set the scene with a single question to the room.

[AUDIENCE POLL] (raise hands or use live polling app)

"How many of you have personally used Phasix mesh or a P4HB-based bioresorbable mesh in your practice in the last two years?"

(Pause for a count.)

Interesting. And for those who haven't - by the end of this session, you'll either be convinced to try it, or you'll know exactly why it may not be right for your patient. That is the goal.

[MOD]

Now, allow me to introduce our distinguished panel. Each of them brings a perspective shaped by real patients, real complications, and real outcomes - not just trial data.

(Brief 20-second introduction per panelist - name, institution, area of expertise only)

Thank you all for being here. Let's get straight to work.

SEGMENT 2: SCENE-SETTING - WHAT IS PHASIX MESH?

(Minutes 4-8)

[MOD]

Before we bring in the clinical scenarios, let's anchor ourselves to the science - briefly.

Phasix mesh is manufactured from Poly-4-hydroxybutyrate, or P4HB - a material that is biologically derived through a fermentation process. It is fully resorbable over 12 to 18 months, broken down by hydrolysis into CO2 and water, cleared through the Krebs cycle. What makes it interesting is its open-pore monofilament structure, which promotes rapid tissue ingrowth and vascularization, and its capacity to stimulate the maturation of collagen from Type III to the more durable Type I.

It is - to put it simply - a scaffold that does its job and then leaves.

[DIRECT → Panelist E]

Professor, from an evidence standpoint - in 2025 and 2026, where do we stand with the data on Phasix? The pooled recurrence rate from the meta-analysis is around 4%. The 5-year Phasix trial showed a recurrence rate of 15.9% in Grade 3 hernias. How do we read these numbers?

(Allow 90 seconds for answer.)

[DIRECT → Panelist A]

And Professor, a quick challenge - biosynthetic absorbable mesh is more expensive than standard synthetic mesh. Do outcomes justify the cost? Give us your instinct from practice.

(Allow 60 seconds.)

SEGMENT 3: CLINICAL SCENARIO 1 - THE CONTAMINATED FIELD

(Minutes 8-17)

[SCENARIO SLIDE 1]

CASE 1: The Contaminated Hernia

A 58-year-old male with Type 2 diabetes (HbA1c 8.4%), previous open appendicectomy, and a midline incisional hernia following a Hartmann's procedure reversal. He now presents with a W3 hernia (EHS classification), with a defect of 12 cm. During surgery, the bowel is entered inadvertently - the field is now Grade CDC III/potentially contaminated. Your scrub nurse asks: "Do we still place the mesh?"

[MOD]

This scenario will be familiar to every surgeon in this room. The contaminated field is where bioresorbable mesh was, in many ways, born.

[DIRECT → Panelist A]

Professor, walk us through your decision tree. Do you place Phasix mesh here, and if so - where? Retromuscular? Onlay? And what makes you choose bioresorbable over biological mesh in this setting?

(Allow 2 minutes.)

[MOD] (bridging)

The data from the Phasix Trial's subgroup analysis of 84 Grade 3 VHWG patients showed a 5-year recurrence rate of 15.9% with no mesh-related complications requiring explantation. And our colleagues at multiple institutions have reported in 2025 that even in CDC Grade IV cases, the majority of patients - over 85% - did not require additional hernia repair at follow-up.

[DIRECT → Panelist B]

Professor, from a reconstructive standpoint - when you have contamination AND a large defect needing component separation, does Phasix give you the tissue reinforcement you need, or are you reaching for something else?

(Allow 90 seconds.)

[OPEN]

Let me open this up - what is your absolute cut-off? Is there a level of contamination - CDC Grade IV, faecal soiling - where you would NOT place ANY mesh, including Phasix?

(Brief 60-second round, each panelist gives a one-line answer.)

[AUDIENCE]

(To the room) - How many of you would place Phasix in a CDC Grade IV field? (Show of hands.) Interesting divide. Let's hold that debate for our Q&A.

SEGMENT 4: CLINICAL SCENARIO 2 - THE HIGH-RISK PATIENT

(Minutes 17-24)

[SCENARIO SLIDE 2]

CASE 2: The High-Risk Patient - Obese, Immunosuppressed

A 47-year-old woman, BMI 42, on long-term prednisolone for Crohn's disease, non-smoker. She underwent a laparotomy for small bowel resection 18 months ago and now presents with a symptomatic W2 incisional hernia. She has had two previous mesh repairs with polypropylene - both eventually required explantation for chronic infection. She says: "I cannot go through that again."

[MOD]

This patient is asking us not just to repair her hernia - she is asking us not to ruin her life again.

[DIRECT → Panelist D]

Professor, this is your territory. Immunosuppression, obesity, prior mesh failure. Does bioresorbable mesh change the risk calculus here? What does the evidence tell us about outcomes in immunocompromised patients specifically?

(Allow 2 minutes.)

[MOD] (bridging)

In 2025, Srivastava and colleagues published in Hernia that P4HB mesh is effective in high-risk patients and contaminated abdomen - with acceptable outcomes even in this cohort. But there's a nuance here that I want to probe.

[DIRECT → Panelist C]

Professor, she's had two failed permanent meshes. There is significant scarring and altered anatomy. From a technical standpoint - does this patient go laparoscopic, robotic, or open? And does your mesh choice change with the approach? I ask because the EU MDR clinical data for laparoscopic Phasix use is still evolving.

(Allow 90 seconds.)

[OPEN]

Quick round - should we be doing weight optimization or disease control before we even consider mesh placement here? What is your threshold - BMI cut-off, steroid dose?

(30 seconds per panelist.)

SEGMENT 5: CLINICAL SCENARIO 3 - THE YOUNG PATIENT / PROPHYLACTIC USE

(Minutes 24-30)

[SCENARIO SLIDE 3]

CASE 3: Prophylactic Mesh Placement

A 32-year-old woman, BMI 27, no comorbidities, undergoes an elective open sigmoid colectomy for recurrent diverticulitis. She asks if there is anything you can do to prevent an incisional hernia. Her mother had two hernia repairs after abdominal surgery. You are considering prophylactic mesh reinforcement of the midline closure.

[MOD]

This scenario brings us to one of the most exciting and most debated new indications for Phasix - prophylactic use. The 2025 EHS data indicates Phasix is now indicated for prophylactic reinforcement of surgical incisions.

[DIRECT → Panelist B]

Professor, is prophylactic bioresorbable mesh the future of elective laparotomy closure in high-risk incisions? Or are we over-treating?

(Allow 90 seconds.)

[MOD] (quick challenge)

Now here is the key tension with Phasix that I want the panel to address directly. The manufacturer's own contraindication states: "Phasix should NOT be used in repairs where permanent wound or organ support from the mesh is required." So in a prophylactic setting - you are relying entirely on the neo-collagen scaffold that forms as the mesh resorbs. Professor, does that concern you?

[DIRECT → Panelist E]

Is there long-term collagen remodeling data that gives you confidence the scaffold holds after 18 months? The multicentre analysis by Bueno-Lledó published in Hernia 2024 reported low recurrence rates - what do we make of that?

(Allow 90 seconds.)

[AUDIENCE INTERACTION]

(To the room) - Quick show of hands: how many of you currently offer prophylactic mesh to patients at high risk of incisional hernia? (Pause.) That number is going to change. Let's keep moving.

SEGMENT 6: CLINICAL SCENARIO 4 - THE INTERESTING / UNUSUAL CASE

(Minutes 30-36)

[SCENARIO SLIDE 4]

CASE 4: The Unusual Case - Pregnancy After Bioresorbable Mesh

A 29-year-old woman underwent abdominal wall reconstruction with Phasix mesh two years ago following a diastasis recti repair complicated by a midline hernia. She is now 10 weeks pregnant and was referred to you for counselling. Her previous surgeon used a large piece of Phasix in a retromuscular position. She asks: "Is my baby safe? Will I need a C-section? Is my hernia going to come back?"

[MOD]

This is a genuinely fascinating case - and one that has now made it into the literature. A 2026 case report in Frontiers in Surgery documented a 10-year follow-up of a pregnancy after bioresorbable abdominal wall reconstruction - with a successful outcome.

[OPEN]

Panel, let's go around quickly. What do you tell this woman? C-section versus vaginal delivery? And what does a fully resorbed mesh mean for the mechanical integrity of her abdominal wall during the stress of pregnancy and labour?

(60-90 seconds per panelist, rapid round.)

[MOD]

This case also invites a broader philosophical point. When the mesh is gone, what are we really left with? Are we trusting the body's own collagen architecture, or are we gambling?

[DIRECT → Panelist E]

Professor, is there a patient population where you would specifically NOT use Phasix - young, active patients with large defects - precisely because the permanent support is absent after resorption?

(Allow 90 seconds.)

SEGMENT 7: CONTRAINDICATIONS, CAUTIONS & CONTROVERSIES

(Minutes 36-40)

[MOD]

We are in the home stretch, and I want to make sure we have been honest about the limitations. Every mesh has a story - not just of success.

Let me give the panel a rapid-fire contraindication challenge. I will name a scenario - I want a one-word or one-line verdict from each of you: Use it / Don't use it / Maybe.

(Keep this energetic and rapid.)

Morbidly obese patient, BMI 55, elective hernia repair, clean field. (Go around.)
Known allergy to tetracycline or kanamycin - remember, the mesh manufacturing process involves both antibiotics. (Go around.)
Bridging repair - no fascial closure possible, mesh as the only structural element. (Go around.)
Parastomal hernia repair - permanent structural support needed at the stoma site long-term. (Go around.)
Patient with active intra-abdominal malignancy - bowel resection and incidental hernia repair. (Go around.)

[MOD]

Number 5 is particularly important - and often underappreciated. The safety and effectiveness of Phasix ST mesh in proximity to existing or excised cancer has not been established. That is a formal warning, not a minor footnote.

[DIRECT → Panelist A]

Professor, what about Phasix ST - the suturable version with the ePTFE anti-adhesion barrier? When do you specifically choose ST over standard Phasix, and does intraperitoneal placement change your contamination calculus?

(Allow 60 seconds.)

SEGMENT 8: PANEL CONSENSUS & TAKE-HOME MESSAGES

(Minutes 40-43)

[MOD]

Before we open to the floor, I want each panelist to give me one sentence - your single most important take-home message about Phasix mesh. One sentence only.

(Go around the panel in order.)

[MOD - Closing synthesis]

Thank you. Let me attempt to distil what our panel has told us today:

Phasix mesh is not a universal solution, and it is not a shortcut. It is a time-limited scaffold - powerful in contaminated fields, promising in prophylaxis, appropriate for patients where permanent implant risks outweigh the need for permanent support. Its contraindication is precise and non-negotiable: where the body cannot be trusted to rebuild its own wall after 12 to 18 months, Phasix should not carry the load alone.

The question we leave you with is not "Is Phasix good?" - the data says it is. The question is "Is this the right patient, the right defect, and the right plane?" That is a surgical decision. That is your decision.

We have two minutes for audience questions - and I suspect there will be many.

SEGMENT 9: AUDIENCE Q&A

(Minutes 43-45)

[MOD]

(To the room) - The floor is open. Please keep questions sharp - one question per person, directed to any panelist.

(Field 2-3 questions. For each, briefly redirect if needed: "Professor X, that's really your domain - would you like to respond?")

(If time allows, a closing provocative prompt:)

[MOD]

(If time remains) - One final provocation for the panel: In ten years, will Phasix - or its next-generation successor - replace permanent synthetic mesh as the standard of care for incisional hernia repair? Yes or no from each of you.

(Rapid yes/no round.)

[MOD - Closing]

Thank you to our extraordinary panelists for their honesty, their experience, and their willingness to disagree with each other constructively. That is how we learn. Thank you to all of you in the audience for your engagement. Please do follow up with our speakers - and I hope you leave today with at least one patient in mind for whom the conversation about Phasix just became relevant.

Thank you.

APPENDIX: MODERATOR'S CHEAT SHEET

Key Clinical Data Points to Have Ready

Parameter	Data
Resorption time	12-18 months
Material	Poly-4-hydroxybutyrate (P4HB)
5-year recurrence (Grade 3 VHWG)	15.9% (Phasix Trial, Ann Surg Open 2023)
Pooled recurrence (meta-analysis)	4% (95% CI: 0-12%)
Pooled complication rate	50% (95% CI: 27-72%)
CDC IV contaminated field SSOPI	~35.4% (unpublished multi-institution data, 2025)
Mesh explantation required	Rare; 1 case in 40+ CDC IV patients in 2025 series
Key antibiotic warning	Tetracycline HCl + kanamycin sulfate used in manufacture
Formal contraindication	Do NOT use where permanent organ/wound support is required
Key contraindication warning	Not for bridging; not near excised/active cancer (Phasix ST)

Pacing Guide

Segment	Time	Cumulative
Opening + Audience Pulse	4 min	4 min
Science anchor + Evidence overview	4 min	8 min
Scenario 1: Contaminated Field	9 min	17 min
Scenario 2: High-Risk Patient	7 min	24 min
Scenario 3: Prophylactic Use	6 min	30 min
Scenario 4: Unusual/Pregnancy Case	6 min	36 min
Contraindications rapid-fire	4 min	40 min
Take-home + Closing	3 min	43 min
Audience Q&A	2 min	45 min

Contingency Lines (if discussion dries up)

"Professor, I sense you disagree with that - say it."
"Let me put the case the other way: why would you NOT use Phasix here?"
"Has anyone on this panel had a Phasix failure? What happened?"
"If this were your family member on the table, what mesh would you use?"

This script is designed to be flexible - you can expand any scenario that generates live debate, and compress or skip the rapid-fire round if the conversation is running rich. The four clinical scenarios cover the full arc: contaminated field, complex comorbidities, prophylaxis, and unusual/reproductive-age cases - every major dimension of bioresorbable mesh decision-making in 2025-2026.

Generate a ppt for the same.

Reading File

Running Command

ls -la /tmp/workspace/ 2>/dev/null || mkdir -p /tmp/workspace && echo "workspace ready"

Generate a ppt for the same.

Reading File

Running Command

mkdir -p /tmp/workspace/phasix-panel && echo "ready"

Writing File

~/phasix-panel/build_ppt.py

from pptx import Presentation
from pptx.util import Inches, Pt, Emu
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.util import Inches, Pt
from io import BytesIO
import copy

# ── Colour palette ──────────────────────────────────────────────────────────
DARK_NAVY   = RGBColor(0x0D, 0x2B, 0x4E)   # deep navy  – backgrounds/headers
MID_BLUE    = RGBColor(0x1A, 0x5E, 0x9E)   # panel blue – accent bars
TEAL        = RGBColor(0x00, 0x96, 0x9E)   # teal       – highlights
ORANGE      = RGBColor(0xE8, 0x6C, 0x1A)   # orange     – case labels / warm accent
LIGHT_GREY  = RGBColor(0xF2, 0xF5, 0xF9)   # slide background (light)
WHITE       = RGBColor(0xFF, 0xFF, 0xFF)
DARK_TEXT   = RGBColor(0x1C, 0x1C, 0x2E)
MID_TEXT    = RGBColor(0x3A, 0x3A, 0x5C)
CASE_BG     = RGBColor(0xFF, 0xF3, 0xE4)   # warm cream for case boxes
CASE_BORDER = RGBColor(0xE8, 0x6C, 0x1A)
BULLET_TEAL = TEAL
GREEN       = RGBColor(0x1A, 0x8A, 0x4A)
RED         = RGBColor(0xC0, 0x23, 0x23)

prs = Presentation()
prs.slide_width  = Inches(13.333)
prs.slide_height = Inches(7.5)
blank_layout = prs.slide_layouts[6]

# ── Helper utilities ─────────────────────────────────────────────────────────

def add_rect(slide, x, y, w, h, fill_color=None, line_color=None, line_width=Pt(0)):
    shape = slide.shapes.add_shape(1, Inches(x), Inches(y), Inches(w), Inches(h))
    shape.line.width = line_width
    if fill_color:
        shape.fill.solid()
        shape.fill.fore_color.rgb = fill_color
    else:
        shape.fill.background()
    if line_color:
        shape.line.color.rgb = line_color
        shape.line.width = line_width if line_width else Pt(1.5)
    else:
        shape.line.fill.background()
    return shape

def add_tb(slide, x, y, w, h, text, size=18, bold=False, color=DARK_TEXT,
           align=PP_ALIGN.LEFT, italic=False, wrap=True, v_anchor=MSO_ANCHOR.TOP,
           margin_left=0.08, margin_top=0.04, margin_right=0.08, margin_bottom=0.04):
    tb = slide.shapes.add_textbox(Inches(x), Inches(y), Inches(w), Inches(h))
    tf = tb.text_frame
    tf.word_wrap = wrap
    tf.vertical_anchor = v_anchor
    tf.margin_left  = Inches(margin_left)
    tf.margin_right = Inches(margin_right)
    tf.margin_top   = Inches(margin_top)
    tf.margin_bottom= Inches(margin_bottom)
    p = tf.paragraphs[0]
    p.alignment = align
    r = p.add_run()
    r.text = text
    r.font.name = "Calibri"
    r.font.size = Pt(size)
    r.font.bold = bold
    r.font.italic = italic
    r.font.color.rgb = color
    return tb, tf

def add_para(tf, text, size=16, bold=False, color=DARK_TEXT,
             align=PP_ALIGN.LEFT, italic=False, space_before=Pt(4), bullet_char=None):
    from pptx.oxml.ns import qn
    from lxml import etree
    p = tf.add_paragraph()
    p.alignment = align
    p.space_before = space_before
    if bullet_char:
        r = p.add_run()
        r.text = bullet_char + "  " + text
    else:
        r = p.add_run()
        r.text = text
    r.font.name = "Calibri"
    r.font.size = Pt(size)
    r.font.bold = bold
    r.font.italic = italic
    r.font.color.rgb = color
    return p

def slide_bg(slide, color=LIGHT_GREY):
    """Fill slide background."""
    bg = slide.background
    fill = bg.fill
    fill.solid()
    fill.fore_color.rgb = color

def top_bar(slide, title, subtitle=None, bar_color=DARK_NAVY, title_color=WHITE,
            sub_color=TEAL, bar_height=1.15):
    """Standard top bar with title."""
    add_rect(slide, 0, 0, 13.333, bar_height, fill_color=bar_color)
    # accent line
    add_rect(slide, 0, bar_height, 13.333, 0.055, fill_color=TEAL)
    add_tb(slide, 0.4, 0.12, 12.0, bar_height - 0.15,
           title, size=30, bold=True, color=title_color,
           align=PP_ALIGN.LEFT, v_anchor=MSO_ANCHOR.MIDDLE)
    if subtitle:
        add_tb(slide, 0.4, bar_height - 0.30, 12.0, 0.4,
               subtitle, size=15, bold=False, color=sub_color,
               align=PP_ALIGN.LEFT)

def footer(slide, text="Panel Discussion | Phasix Mesh in Surgery | 2026"):
    add_rect(slide, 0, 7.22, 13.333, 0.28, fill_color=DARK_NAVY)
    add_tb(slide, 0.4, 7.24, 12.5, 0.24,
           text, size=10, color=RGBColor(0xAA, 0xC4, 0xDF),
           align=PP_ALIGN.CENTER, margin_top=0, margin_bottom=0)

def section_label(slide, text, x=0.4, y=1.32, color=TEAL):
    add_tb(slide, x, y, 12.0, 0.3, text.upper(),
           size=10, bold=True, color=color, align=PP_ALIGN.LEFT,
           margin_top=0, margin_bottom=0)

def divider(slide, y=1.70, color=MID_BLUE, width=12.5, x=0.4):
    add_rect(slide, x, y, width, 0.025, fill_color=color)

def case_box(slide, x, y, w, h, case_num, label, lines, label_color=ORANGE):
    """Styled clinical case card."""
    # shadow
    add_rect(slide, x+0.06, y+0.07, w, h, fill_color=RGBColor(0xD0,0xD8,0xE8))
    # main box
    add_rect(slide, x, y, w, h, fill_color=WHITE, line_color=CASE_BORDER, line_width=Pt(2))
    # top accent stripe
    add_rect(slide, x, y, w, 0.32, fill_color=label_color)
    # case label
    add_tb(slide, x+0.12, y+0.03, w-0.2, 0.28,
           f"CASE {case_num}  |  {label}", size=11, bold=True,
           color=WHITE, margin_top=0, margin_bottom=0)
    # body text
    tb, tf = add_tb(slide, x+0.15, y+0.40, w-0.28, h-0.55,
                    lines[0], size=12, color=DARK_TEXT, wrap=True,
                    margin_left=0.05, margin_top=0.03)
    for line in lines[1:]:
        add_para(tf, line, size=12, color=DARK_TEXT, space_before=Pt(3))

def bullet_block(slide, x, y, w, h, items, size=16, heading=None,
                 heading_color=MID_BLUE, bullet="▸", item_color=DARK_TEXT,
                 bg_color=None, border_color=None):
    if bg_color:
        add_rect(slide, x, y, w, h, fill_color=bg_color,
                 line_color=border_color, line_width=Pt(1.2) if border_color else Pt(0))
    tb, tf = add_tb(slide, x+0.12, y+0.08, w-0.22, h-0.15,
                    heading if heading else items[0],
                    size=size, bold=True if heading else False,
                    color=heading_color if heading else item_color, wrap=True,
                    margin_left=0.04, margin_top=0.04)
    start = 0 if not heading else 0
    items_to_add = items if not heading else items
    for itm in items_to_add:
        add_para(tf, itm, size=size-1, color=item_color,
                 space_before=Pt(5), bullet_char=bullet)
    return tb, tf

def icon_kv(slide, x, y, key, val, key_color=MID_BLUE, val_color=DARK_TEXT):
    add_tb(slide, x, y, 2.2, 0.32, key, size=12, bold=True, color=key_color,
           margin_left=0, margin_top=0)
    add_tb(slide, x+2.25, y, 4.0, 0.32, val, size=12, color=val_color,
           margin_left=0, margin_top=0)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 1 — TITLE SLIDE
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, DARK_NAVY)

# diagonal accent graphic (top-right)
add_rect(s, 9.8, 0, 3.533, 7.5, fill_color=RGBColor(0x12, 0x3B, 0x6E))
add_rect(s, 11.5, 0, 1.833, 7.5, fill_color=RGBColor(0x17, 0x4E, 0x8A))

# teal accent bar left
add_rect(s, 0, 0, 0.18, 7.5, fill_color=TEAL)

# horizontal rule
add_rect(s, 0.4, 3.55, 9.0, 0.06, fill_color=TEAL)

# Title
tb, tf = add_tb(s, 0.55, 1.1, 9.0, 1.5,
                "USE OF PHASIX MESH IN SURGERY",
                size=38, bold=True, color=WHITE,
                align=PP_ALIGN.LEFT, wrap=True,
                v_anchor=MSO_ANCHOR.MIDDLE)

# Sub
add_tb(s, 0.55, 2.75, 9.0, 0.55,
       "Bioresorbable P4HB Mesh — Science, Indications & Clinical Practice",
       size=18, color=TEAL, align=PP_ALIGN.LEFT)

# Panel label
add_rect(s, 0.55, 3.75, 5.5, 0.50, fill_color=RGBColor(0x1A, 0x5E, 0x9E))
add_tb(s, 0.65, 3.78, 5.3, 0.44,
       "EXPERT PANEL DISCUSSION  |  40-45 MINUTES",
       size=13, bold=True, color=WHITE, align=PP_ALIGN.LEFT,
       margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)

# Details
add_tb(s, 0.55, 4.42, 8.0, 0.35,
       "Moderated Panel  ·  5 Renowned Panelists  ·  Interactive Clinical Scenarios",
       size=13, color=RGBColor(0xAA, 0xC4, 0xDF), align=PP_ALIGN.LEFT)
add_tb(s, 0.55, 4.85, 5.0, 0.30,
       "July 2026",
       size=13, color=RGBColor(0x88, 0xAA, 0xCC), align=PP_ALIGN.LEFT)

# Mesh label on right panel
add_tb(s, 10.0, 2.8, 3.0, 0.5, "PHASIX™", size=28, bold=True,
       color=TEAL, align=PP_ALIGN.CENTER)
add_tb(s, 10.0, 3.35, 3.0, 0.4, "Poly-4-Hydroxybutyrate", size=11,
       color=RGBColor(0x88, 0xAA, 0xCC), align=PP_ALIGN.CENTER)
add_tb(s, 10.0, 3.75, 3.0, 0.35, "Fully Bioresorbable", size=11,
       color=RGBColor(0x88, 0xAA, 0xCC), align=PP_ALIGN.CENTER)
add_tb(s, 10.0, 4.1, 3.0, 0.35, "12-18 Month Resorption", size=11,
       color=RGBColor(0x88, 0xAA, 0xCC), align=PP_ALIGN.CENTER)

footer(s, "Panel Discussion | Use of Phasix Mesh in Surgery | 2026")

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 2 — PANEL AGENDA / STRUCTURE
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, LIGHT_GREY)
top_bar(s, "Panel Structure & Agenda", subtitle="40-45 Minute Interactive Discussion")
footer(s)

segments = [
    ("01", "Opening & Scene-Setting", "0-4 min", "Audience pulse • Panelist introductions"),
    ("02", "The Science of Phasix", "4-8 min", "P4HB biology • Evidence summary • Cost-efficacy"),
    ("03", "Case 1: Contaminated Field", "8-17 min", "CDC III/IV hernia • Mesh choice decision tree"),
    ("04", "Case 2: High-Risk Patient", "17-24 min", "Obese + immunosuppressed • Technique & positioning"),
    ("05", "Case 3: Prophylactic Use", "24-30 min", "Primary closure reinforcement • Young patients"),
    ("06", "Case 4: Unusual Case", "30-36 min", "Pregnancy after AWR • Long-term scaffold fate"),
    ("07", "Contraindications Rapid-Fire", "36-40 min", "Panel verdict on 5 challenging scenarios"),
    ("08", "Take-Homes & Q&A", "40-45 min", "Consensus messages • Audience questions"),
]

row_h = 0.60
start_y = 1.28
for i, (num, title, timing, desc) in enumerate(segments):
    y = start_y + i * row_h
    bg = WHITE if i % 2 == 0 else RGBColor(0xE8, 0xEF, 0xF8)
    add_rect(s, 0.35, y, 12.6, row_h - 0.05, fill_color=bg)
    # number pill
    add_rect(s, 0.35, y, 0.55, row_h - 0.05, fill_color=MID_BLUE)
    add_tb(s, 0.36, y+0.02, 0.52, row_h-0.1, num, size=14, bold=True,
           color=WHITE, align=PP_ALIGN.CENTER, v_anchor=MSO_ANCHOR.MIDDLE,
           margin_top=0, margin_bottom=0)
    # title
    add_tb(s, 1.0, y+0.08, 4.2, 0.38, title, size=13, bold=True,
           color=DARK_NAVY, margin_top=0, margin_bottom=0)
    # timing
    add_rect(s, 5.3, y+0.1, 1.4, 0.34, fill_color=TEAL)
    add_tb(s, 5.32, y+0.12, 1.36, 0.30, timing, size=11, bold=True,
           color=WHITE, align=PP_ALIGN.CENTER, v_anchor=MSO_ANCHOR.MIDDLE,
           margin_top=0, margin_bottom=0)
    # desc
    add_tb(s, 6.85, y+0.10, 6.0, 0.38, desc, size=11,
           color=MID_TEXT, margin_top=0, margin_bottom=0)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 3 — THE SCIENCE: WHAT IS PHASIX?
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, LIGHT_GREY)
top_bar(s, "What is Phasix™ Mesh?", subtitle="Poly-4-Hydroxybutyrate (P4HB) — The Science Behind the Scaffold")
footer(s)

# Left column — properties
add_rect(s, 0.35, 1.30, 6.1, 5.6, fill_color=WHITE,
         line_color=RGBColor(0xCC,0xD8,0xEC), line_width=Pt(1))
add_rect(s, 0.35, 1.30, 6.1, 0.42, fill_color=MID_BLUE)
add_tb(s, 0.55, 1.33, 5.8, 0.36, "MATERIAL & PROPERTIES", size=12, bold=True,
       color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)

props = [
    ("Material", "Poly-4-Hydroxybutyrate (P4HB) — biologically derived via fermentation"),
    ("Structure", "Open-pore monofilament scaffold — promotes rapid tissue ingrowth"),
    ("Resorption", "Fully resorbed in 12-18 months via hydrolysis"),
    ("Metabolites", "Broken down to CO₂ + H₂O — cleared by the Krebs cycle"),
    ("Collagen", "Promotes Type III → Type I collagen maturation at repair site"),
    ("Immune resp.", "Minimal foreign body reaction; early anti-inflammatory macrophage response"),
    ("Strength", "Maintains mechanical strength during critical early healing phase"),
]
py = 1.85
for k, v in props:
    add_rect(s, 0.38, py, 5.9, 0.52, fill_color=RGBColor(0xF0,0xF4,0xFB))
    add_tb(s, 0.50, py+0.05, 1.4, 0.38, k+":", size=11, bold=True,
           color=MID_BLUE, margin_top=0, margin_bottom=0)
    add_tb(s, 1.92, py+0.05, 4.2, 0.42, v, size=11, color=DARK_TEXT,
           wrap=True, margin_top=0, margin_bottom=0)
    py += 0.57

# Right column — key numbers
add_rect(s, 6.75, 1.30, 6.25, 5.6, fill_color=WHITE,
         line_color=RGBColor(0xCC,0xD8,0xEC), line_width=Pt(1))
add_rect(s, 6.75, 1.30, 6.25, 0.42, fill_color=DARK_NAVY)
add_tb(s, 6.92, 1.33, 5.9, 0.36, "KEY CLINICAL DATA", size=12, bold=True,
       color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)

stats = [
    ("4%", "Pooled recurrence rate", "(Meta-analysis, 95% CI 0-12%)", TEAL),
    ("15.9%", "5-yr recurrence, Grade 3 VHWG", "(Phasix Trial, Ann Surg Open 2023)", MID_BLUE),
    ("50%", "Pooled complication rate", "(95% CI 27-72% — includes seromas)", ORANGE),
    (">85%", "Patients NOT needing re-repair", "(CDC IV contaminated field, 2025)", GREEN),
]
sy = 1.85
for val, label, note, col in stats:
    add_rect(s, 6.80, sy, 6.1, 1.20, fill_color=RGBColor(0xF0,0xF4,0xFB))
    add_rect(s, 6.80, sy, 0.18, 1.20, fill_color=col)
    add_tb(s, 7.10, sy+0.10, 2.0, 0.65, val, size=30, bold=True,
           color=col, align=PP_ALIGN.LEFT, v_anchor=MSO_ANCHOR.MIDDLE,
           margin_top=0, margin_bottom=0)
    add_tb(s, 9.15, sy+0.10, 3.6, 0.38, label, size=12, bold=True,
           color=DARK_NAVY, wrap=True, margin_top=0, margin_bottom=0)
    add_tb(s, 9.15, sy+0.52, 3.6, 0.32, note, size=10, color=MID_TEXT,
           italic=True, wrap=True, margin_top=0, margin_bottom=0)
    sy += 1.30

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 4 — INDICATIONS & CONTRAINDICATIONS
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, LIGHT_GREY)
top_bar(s, "Indications & Contraindications", subtitle="Official Labelling + Expert Clinical Context")
footer(s)

# Left — indications
add_rect(s, 0.35, 1.30, 5.9, 5.7, fill_color=RGBColor(0xF0,0xFB,0xF4),
         line_color=GREEN, line_width=Pt(1.5))
add_rect(s, 0.35, 1.30, 5.9, 0.45, fill_color=GREEN)
add_tb(s, 0.55, 1.33, 5.6, 0.38, "✔  INDICATIONS", size=13, bold=True,
       color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)

indications = [
    "Ventral & incisional hernia repair (clean & contaminated fields)",
    "Abdominal fascial defect repair — bridging or reinforcement",
    "Plastic & reconstructive surgery — soft tissue reinforcement",
    "Abdominal wall reconstruction (AWR) with component separation",
    "Hiatal hernia repair (Phasix ST variant)",
    "Prophylactic incision reinforcement to prevent hernia formation",
    "High-risk patients where permanent mesh infection risk is elevated",
    "Patients with prior synthetic mesh failure / chronic infection",
    "Reproductive-age women where future abdominal surgery is anticipated",
]
iy = 1.88
for item in indications:
    add_tb(s, 0.60, iy, 5.5, 0.48, "▸  " + item, size=11.5,
           color=DARK_TEXT, wrap=True, margin_left=0.05, margin_top=0.02)
    iy += 0.50

# Right — contraindications + warnings
add_rect(s, 6.55, 1.30, 6.45, 2.80, fill_color=RGBColor(0xFD,0xF0,0xF0),
         line_color=RED, line_width=Pt(1.5))
add_rect(s, 6.55, 1.30, 6.45, 0.45, fill_color=RED)
add_tb(s, 6.72, 1.33, 6.2, 0.38, "✘  CONTRAINDICATIONS", size=13, bold=True,
       color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)

contras = [
    "Where PERMANENT wound/organ support is required (formal CI)",
    "Bridging repair — fascial closure must be achievable",
    "Proximity to existing or excised malignancy (Phasix ST)",
    "Known allergy to tetracycline HCl or kanamycin sulfate",
    "Parastomal hernia where lifelong structural support is essential",
]
cy = 1.88
for item in contras:
    add_tb(s, 6.72, cy, 6.1, 0.50, "✘  " + item, size=11.5,
           color=RED, wrap=True, margin_left=0.05, margin_top=0.02)
    cy += 0.52

# Warnings box
add_rect(s, 6.55, 4.22, 6.45, 2.78, fill_color=RGBColor(0xFF,0xF8,0xEE),
         line_color=ORANGE, line_width=Pt(1.5))
add_rect(s, 6.55, 4.22, 6.45, 0.45, fill_color=ORANGE)
add_tb(s, 6.72, 4.25, 6.2, 0.38, "⚠  WARNINGS & PRECAUTIONS", size=13, bold=True,
       color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)

warnings = [
    "Antibiotic sensitivity: manufacturing exposes to tetracycline HCl + kanamycin sulfate",
    "Laparoscopic/robotic use: EU MDR clinical data not yet fully established",
    "Phasix ST: coated side MUST face bowel/sensitive organs — orientation critical",
    "Not for proximity to abdominopelvic cavity cancer (Phasix ST label)",
    "Adverse reactions: seroma, infection, pain, adhesion, fistula, recurrence",
]
wy = 4.78
for item in warnings:
    add_tb(s, 6.72, wy, 6.1, 0.46, "⚠  " + item, size=11,
           color=RGBColor(0x7A, 0x3A, 0x00), wrap=True, margin_left=0.05, margin_top=0.02)
    wy += 0.46

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 5 — CASE 1: CONTAMINATED FIELD
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, LIGHT_GREY)
top_bar(s, "Clinical Scenario 1 — The Contaminated Field", subtitle="CDC Grade III / Potentially Contaminated Hernia Repair")
footer(s)

# Case card
add_rect(s, 0.35, 1.28, 12.65, 1.82, fill_color=CASE_BG,
         line_color=CASE_BORDER, line_width=Pt(2))
add_rect(s, 0.35, 1.28, 12.65, 0.36, fill_color=ORANGE)
add_tb(s, 0.52, 1.30, 12.3, 0.32,
       "CASE 1  |  58-year-old male  |  T2DM (HbA1c 8.4%)  |  Post-Hartmann's reversal  |  W3 midline incisional hernia  |  Defect 12 cm",
       size=11.5, bold=True, color=WHITE, margin_top=0, margin_bottom=0,
       v_anchor=MSO_ANCHOR.MIDDLE)
add_tb(s, 0.52, 1.70, 12.2, 0.50,
       "Intraoperative enterotomy — field now CDC Grade III (potentially contaminated). Fascial closure achievable with component separation. "
       "Scrub nurse asks: 'Do we still place the mesh?'",
       size=12, color=DARK_TEXT, wrap=True, margin_left=0.05, margin_top=0.02)
add_tb(s, 0.52, 2.82, 12.2, 0.26,
       "Key Question: Place Phasix vs. biological mesh vs. primary repair only? Plane of placement? Timing?",
       size=11.5, bold=True, italic=True, color=DARK_NAVY, wrap=True,
       margin_left=0.05, margin_top=0.02)

# Two columns below
# Left — Evidence
add_rect(s, 0.35, 3.22, 6.1, 3.78, fill_color=WHITE,
         line_color=RGBColor(0xCC,0xD8,0xEC), line_width=Pt(1))
add_rect(s, 0.35, 3.22, 6.1, 0.38, fill_color=MID_BLUE)
add_tb(s, 0.52, 3.25, 5.8, 0.32, "EVIDENCE SNAPSHOT", size=12, bold=True,
       color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)

ev_items = [
    "5-yr recurrence 15.9% in VHWG Grade 3 (Phasix Trial, Ann Surg Open 2023)",
    "No mesh-related complications requiring explantation at 5 years",
    ">85% CDC IV patients did NOT require re-repair at follow-up (2025 series)",
    "Only 1 mesh infection requiring excision in 40+ CDC IV cases (multi-institution 2025)",
    "SSOPI rate ~35.4% in CDC IV contaminated field — acceptable range",
    "P4HB minimal foreign-body reaction resolves as mesh resorbs",
    "Preclinical: superior resistance to Staph. aureus vs. permanent synthetic mesh",
]
ey = 3.72
for item in ev_items:
    add_tb(s, 0.50, ey, 5.8, 0.44, "▸  " + item, size=11,
           color=DARK_TEXT, wrap=True, margin_left=0.05, margin_top=0.01)
    ey += 0.46

# Right — Panel discussion prompts
add_rect(s, 6.65, 3.22, 6.35, 3.78, fill_color=WHITE,
         line_color=RGBColor(0xCC,0xD8,0xEC), line_width=Pt(1))
add_rect(s, 6.65, 3.22, 6.35, 0.38, fill_color=TEAL)
add_tb(s, 6.82, 3.25, 6.0, 0.32, "PANEL DISCUSSION POINTS", size=12, bold=True,
       color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)

panel_pts = [
    "Decision tree: bioresorbable vs. biological mesh in contamination",
    "Plane of placement: retromuscular vs. onlay vs. IPOM",
    "Role of component separation (TAR/Rives-Stoppa) in this context",
    "Absolute contamination cut-off: CDC IV faecal soiling — any mesh?",
    "Antibiotic irrigation + drain protocols alongside Phasix",
    "When would you abandon mesh entirely and stage the repair?",
]
pp = 3.72
for item in panel_pts:
    add_tb(s, 6.80, pp, 6.0, 0.44, "▶  " + item, size=11,
           color=DARK_TEXT, wrap=True, margin_left=0.05, margin_top=0.01)
    pp += 0.50

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 6 — CASE 2: HIGH-RISK PATIENT
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, LIGHT_GREY)
top_bar(s, "Clinical Scenario 2 — The High-Risk Patient", subtitle="Obese + Immunosuppressed + Prior Mesh Failure")
footer(s)

add_rect(s, 0.35, 1.28, 12.65, 1.88, fill_color=CASE_BG,
         line_color=CASE_BORDER, line_width=Pt(2))
add_rect(s, 0.35, 1.28, 12.65, 0.36, fill_color=ORANGE)
add_tb(s, 0.52, 1.30, 12.3, 0.32,
       "CASE 2  |  47-year-old woman  |  BMI 42  |  Crohn's disease on long-term prednisolone  |  W2 incisional hernia post-bowel resection",
       size=11.5, bold=True, color=WHITE, margin_top=0, margin_bottom=0,
       v_anchor=MSO_ANCHOR.MIDDLE)
add_tb(s, 0.52, 1.70, 12.2, 0.55,
       "Two prior polypropylene mesh repairs — both required explantation for chronic infection. "
       "Patient states: 'I cannot go through that again.' Fascial defect 8 cm. No active bowel disease.",
       size=12, color=DARK_TEXT, wrap=True, margin_left=0.05, margin_top=0.02)
add_tb(s, 0.52, 2.88, 12.2, 0.26,
       "Key Question: Does bioresorbable mesh change the risk calculus? Open vs. MIS approach? Weight / steroid optimisation threshold?",
       size=11.5, bold=True, italic=True, color=DARK_NAVY, wrap=True,
       margin_left=0.05, margin_top=0.02)

# Risk factor boxes
risk_factors = [
    ("BMI 42", "Obesity → ↑ SSI risk, ↑ abdominal wall tension, ↑ seroma", RED),
    ("Prednisolone", "Impaired collagen synthesis → scaffold cannot rely on neotissue", ORANGE),
    ("Crohn's", "Transmural inflammation → fistula / entero-cutaneous risk", ORANGE),
    ("Prior mesh failure", "Altered anatomy, scarring, biofilm — re-seeding of infection", RED),
]
rx = 0.35
for label, desc, col in risk_factors:
    add_rect(s, rx, 3.30, 3.05, 1.10, fill_color=WHITE,
             line_color=col, line_width=Pt(2))
    add_rect(s, rx, 3.30, 3.05, 0.32, fill_color=col)
    add_tb(s, rx+0.12, 3.32, 2.85, 0.28, label, size=12, bold=True,
           color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)
    add_tb(s, rx+0.12, 3.68, 2.82, 0.62, desc, size=11, color=DARK_TEXT,
           wrap=True, margin_left=0.05, margin_top=0.02)
    rx += 3.18

# Panel discussion points
add_rect(s, 0.35, 4.55, 12.65, 2.5, fill_color=WHITE,
         line_color=RGBColor(0xCC,0xD8,0xEC), line_width=Pt(1))
add_rect(s, 0.35, 4.55, 12.65, 0.38, fill_color=MID_BLUE)
add_tb(s, 0.52, 4.58, 12.2, 0.32, "PANEL DISCUSSION POINTS & EVIDENCE", size=12, bold=True,
       color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)

panel2 = [
    ("Srivastava et al. 2025 (Hernia)", "P4HB effective in high-risk patients + contaminated abdomen — acceptable outcomes"),
    ("Approach", "Open vs. laparoscopic vs. robotic: EU MDR data for laparoscopic Phasix still evolving"),
    ("Optimisation threshold", "BMI cut-off before elective repair? Steroid taper protocol? HbA1c target?"),
    ("Retromuscular positioning", "Preferred plane — reduces SSI exposure, improves tissue coverage"),
    ("Patient counselling", "'The mesh dissolves — your tissue must do the work': honest expectation-setting"),
]
py2 = 5.05
for ref, desc in panel2:
    add_tb(s, 0.50, py2, 2.4, 0.38, ref+":", size=11, bold=True,
           color=TEAL, margin_top=0, margin_bottom=0)
    add_tb(s, 2.95, py2, 10.0, 0.42, desc, size=11, color=DARK_TEXT,
           wrap=True, margin_top=0, margin_bottom=0)
    py2 += 0.43

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 7 — CASE 3: PROPHYLACTIC USE
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, LIGHT_GREY)
top_bar(s, "Clinical Scenario 3 — Prophylactic Mesh Placement", subtitle="Preventing Incisional Hernia in Elective Laparotomy")
footer(s)

add_rect(s, 0.35, 1.28, 12.65, 1.72, fill_color=CASE_BG,
         line_color=CASE_BORDER, line_width=Pt(2))
add_rect(s, 0.35, 1.28, 12.65, 0.36, fill_color=ORANGE)
add_tb(s, 0.52, 1.30, 12.3, 0.32,
       "CASE 3  |  32-year-old woman  |  BMI 27  |  No comorbidities  |  Elective open sigmoid colectomy for recurrent diverticulitis",
       size=11.5, bold=True, color=WHITE, margin_top=0, margin_bottom=0,
       v_anchor=MSO_ANCHOR.MIDDLE)
add_tb(s, 0.52, 1.70, 12.2, 0.52,
       "Strong family history of incisional hernia. Patient enquires about hernia prevention. "
       "Considering prophylactic bioresorbable mesh reinforcement of midline closure. Clean field (CDC Grade I).",
       size=12, color=DARK_TEXT, wrap=True, margin_left=0.05, margin_top=0.02)
add_tb(s, 0.52, 2.76, 12.2, 0.26,
       "Key Question: Is prophylactic bioresorbable mesh the future of elective laparotomy closure? Or over-treatment? What happens after mesh resorption?",
       size=11.5, bold=True, italic=True, color=DARK_NAVY, wrap=True,
       margin_left=0.05, margin_top=0.02)

# Three columns
col_data = [
    ("FOR Prophylaxis", GREEN, [
        "2025: Phasix now formally indicated for prophylactic incision reinforcement",
        "Phasix EHS 2025 brochure: designed to 'protect quality of life after surgery'",
        "Collagen scaffold matures: Type III → Type I over resorption period",
        "Avoids the morbidity of a future hernia repair entirely",
        "Relevant in midline laparotomy, stoma formation, high-risk closures",
    ]),
    ("AGAINST / Cautions", RED, [
        "Formal CI: not for use where PERMANENT support is required",
        "After resorption: tissue alone bears the load — relies on neotissue quality",
        "Young patient: decades of abdominal stress ahead — scaffold gone in 18 months",
        "No long-term RCT data on prophylactic Phasix beyond 5 years",
        "Cost-benefit unclear in low-risk, young, BMI-normal patients",
    ]),
    ("Expert Considerations", MID_BLUE, [
        "Risk-stratify: BMI, prior surgery, planned stoma, steroid use",
        "Bueno-Lledó 2024 (Hernia): long-term results show sustained low recurrence",
        "Preclinical: ingrown tissue retains strength after mesh resorption",
        "Shared decision-making: patient must understand the bioresorbable concept",
        "Consider mesh-augmented mass closure vs. prophylactic overlay",
    ]),
]
cx = 0.35
for col_title, col_color, items in col_data:
    add_rect(s, cx, 3.18, 4.12, 3.82, fill_color=WHITE,
             line_color=col_color, line_width=Pt(1.5))
    add_rect(s, cx, 3.18, 4.12, 0.38, fill_color=col_color)
    add_tb(s, cx+0.12, 3.21, 3.9, 0.32, col_title, size=12, bold=True,
           color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)
    iy = 3.66
    for item in items:
        add_tb(s, cx+0.14, iy, 3.86, 0.54, "▸  " + item, size=10.5,
               color=DARK_TEXT, wrap=True, margin_left=0.04, margin_top=0.01)
        iy += 0.54
    cx += 4.30

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 8 — CASE 4: UNUSUAL CASE / PREGNANCY
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, LIGHT_GREY)
top_bar(s, "Clinical Scenario 4 — The Unusual Case", subtitle="Pregnancy After Abdominal Wall Reconstruction with Bioresorbable Mesh")
footer(s)

add_rect(s, 0.35, 1.28, 12.65, 1.82, fill_color=CASE_BG,
         line_color=CASE_BORDER, line_width=Pt(2))
add_rect(s, 0.35, 1.28, 12.65, 0.36, fill_color=ORANGE)
add_tb(s, 0.52, 1.30, 12.3, 0.32,
       "CASE 4  |  29-year-old woman  |  Diastasis recti + midline hernia  |  AWR with large retromuscular Phasix mesh 2 years prior  |  Now 10 weeks pregnant",
       size=11.5, bold=True, color=WHITE, margin_top=0, margin_bottom=0,
       v_anchor=MSO_ANCHOR.MIDDLE)
add_tb(s, 0.52, 1.70, 12.2, 0.55,
       "Referred for counselling. Mesh fully absorbed. She asks: 'Is my baby safe? Will I need a C-section? "
       "Will my hernia come back?' Her obstetrician has never seen this situation before.",
       size=12, color=DARK_TEXT, wrap=True, margin_left=0.05, margin_top=0.02)
add_tb(s, 0.52, 2.88, 12.2, 0.26,
       "Key Question: Mode of delivery? Mechanical integrity of neo-collagen wall under pregnancy/labour stress? Recurrence risk?",
       size=11.5, bold=True, italic=True, color=DARK_NAVY, wrap=True,
       margin_left=0.05, margin_top=0.02)

# Literature highlight
add_rect(s, 0.35, 3.26, 7.5, 1.30, fill_color=RGBColor(0xE8,0xF4,0xFF),
         line_color=MID_BLUE, line_width=Pt(1.5))
add_rect(s, 0.35, 3.26, 0.22, 1.30, fill_color=MID_BLUE)
add_tb(s, 0.72, 3.32, 7.0, 0.28, "LITERATURE: Putko et al. (2026) — Front Surg", size=11, bold=True,
       color=MID_BLUE, margin_top=0, margin_bottom=0)
add_tb(s, 0.72, 3.65, 7.0, 0.78,
       "Case report: bioresorbable implant in anterior AWR in women of reproductive age — "
       "successful pregnancy AND 10-year follow-up documented. No catastrophic abdominal wall failure reported.",
       size=11, color=DARK_TEXT, wrap=True, margin_left=0.04, margin_top=0.02)

# Right — questions for panel
add_rect(s, 8.05, 3.26, 5.0, 1.30, fill_color=RGBColor(0xFF,0xF3,0xE4),
         line_color=ORANGE, line_width=Pt(1.5))
add_rect(s, 8.05, 3.26, 0.22, 1.30, fill_color=ORANGE)
add_tb(s, 8.42, 3.32, 4.5, 0.28, "KEY CLINICAL QUESTION", size=11, bold=True,
       color=ORANGE, margin_top=0, margin_bottom=0)
add_tb(s, 8.42, 3.65, 4.5, 0.78,
       "When the mesh is gone — is the body's own collagen strong enough for the mechanical "
       "stress of pregnancy, labour, and delivery?",
       size=11, color=DARK_TEXT, wrap=True, margin_left=0.04, margin_top=0.02)

# Panel points in grid
panel4 = [
    ("Delivery mode", "No universal consensus — individualise based on defect size, repair quality, obstetric factors"),
    ("C-section consideration", "Preferred if previous large AWR + diastasis — avoids extreme Valsalva forces on neo-collagen wall"),
    ("Recurrence risk", "No definitive data; anecdotal evidence from 2026 case report is reassuring at 10 years"),
    ("Collagen quality", "Type I collagen matures over resorption period — but individual variation in remodelling is real"),
    ("Counselling point", "Patient must understand: 'The mesh is gone — your tissue is the repair now'"),
    ("Multidisciplinary", "Involve obstetrician + hernia surgeon in joint counselling — unfamiliar territory for most OB teams"),
]
px = 0.35
py = 4.68
toggle = True
for key, val in panel4:
    bg = RGBColor(0xF0,0xF4,0xFB) if toggle else WHITE
    add_rect(s, px, py, 12.65, 0.42, fill_color=bg)
    add_tb(s, px+0.12, py+0.05, 2.5, 0.32, key+":", size=11, bold=True,
           color=MID_BLUE, margin_top=0, margin_bottom=0)
    add_tb(s, px+2.72, py+0.05, 10.1, 0.38, val, size=11, color=DARK_TEXT,
           wrap=True, margin_top=0, margin_bottom=0)
    py += 0.42
    toggle = not toggle

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 9 — CONTRAINDICATIONS RAPID-FIRE
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, LIGHT_GREY)
top_bar(s, "Contraindications Rapid-Fire", subtitle="Panel Verdict — Use it / Don't Use it / Maybe?")
footer(s)

add_tb(s, 0.4, 1.26, 12.5, 0.32,
       "Moderator presents each scenario — each panelist gives a one-word verdict: USE IT  |  DON'T USE IT  |  MAYBE",
       size=12, bold=True, color=DARK_NAVY, italic=True, margin_top=0)

scenarios = [
    ("1", "Morbidly Obese Patient",
     "BMI 55, elective hernia repair, clean field. No prior mesh. Technically achievable fascial closure.",
     "Hotly debated — obesity ↑ seroma/SSI risk but Phasix avoids long-term mesh complications of permanent implant"),
    ("2", "Antibiotic Allergy",
     "Known allergy to tetracycline or kanamycin sulfate. Manufacturing process uses both antibiotics.",
     "Formal WARNING — safety in hypersensitive patients unknown. DO NOT USE without allergy workup."),
    ("3", "Bridging Repair",
     "Large defect — fascial closure is NOT possible. Mesh would be the sole structural element permanently.",
     "FORMAL CONTRAINDICATION — Phasix is NOT for use where permanent wound support is required."),
    ("4", "Parastomal Hernia",
     "Permanent structural support needed at stoma site for the patient's lifetime.",
     "Generally avoid — lifelong mechanical demand cannot be met by a 12-18 month scaffold alone."),
    ("5", "Active Malignancy",
     "Bowel resection for cancer — incidental hernia repair. Phasix ST would be intraperitoneal.",
     "Phasix ST formal warning: safety near existing/excised cancer NOT established. Exercise caution."),
]
sy = 1.68
for num, title, scenario, verdict in scenarios:
    add_rect(s, 0.35, sy, 12.65, 1.00, fill_color=WHITE,
             line_color=RGBColor(0xCC,0xD8,0xEC), line_width=Pt(0.8))
    # number
    add_rect(s, 0.35, sy, 0.52, 1.00, fill_color=DARK_NAVY)
    add_tb(s, 0.35, sy+0.22, 0.52, 0.55, num, size=16, bold=True,
           color=WHITE, align=PP_ALIGN.CENTER, margin_top=0, margin_bottom=0,
           v_anchor=MSO_ANCHOR.MIDDLE)
    # title + scenario
    add_tb(s, 0.95, sy+0.05, 5.8, 0.32, title, size=12, bold=True,
           color=DARK_NAVY, margin_top=0, margin_bottom=0)
    add_tb(s, 0.95, sy+0.40, 5.8, 0.52, scenario, size=10.5,
           color=MID_TEXT, wrap=True, margin_top=0, margin_bottom=0)
    # verdict
    add_rect(s, 6.9, sy+0.12, 6.0, 0.76, fill_color=RGBColor(0xF0,0xF4,0xFB))
    add_tb(s, 7.05, sy+0.14, 5.8, 0.66, "Panel context: " + verdict,
           size=10.5, color=DARK_TEXT, italic=True, wrap=True,
           margin_left=0.05, margin_top=0.03)
    sy += 1.06

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 10 — PHASIX vs ALTERNATIVES COMPARISON
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, LIGHT_GREY)
top_bar(s, "Phasix vs. Alternative Mesh Options", subtitle="Helping the Panel Frame the Choice for Each Patient")
footer(s)

headers = ["Feature", "Phasix™ (P4HB)", "Permanent Synthetic\n(PP/PVDF)", "Biological Mesh\n(porcine/bovine)", "Composite Mesh\n(PP + absorbable)"]
col_w = [2.2, 2.5, 2.5, 2.6, 2.4]
col_x = [0.3, 2.55, 5.1, 7.65, 10.3]
header_colors = [DARK_NAVY, MID_BLUE, RED, GREEN, TEAL]

rows = [
    ["Resorption",       "Full (12-18 mo)", "None (permanent)", "Full / partial",    "Partial"],
    ["Tissue ingrowth",  "Rapid + strong",  "Good",             "Variable",          "Good (PP layer)"],
    ["Infection risk",   "Low – resorbs",   "Biofilm risk",     "Low – degrades",    "Moderate"],
    ["Cost",             "High",            "Low",              "Very High",         "Moderate"],
    ["Contaminated field","Yes (evidence)", "Avoid",            "Yes (standard)",    "Caution"],
    ["Bridging repair",  "NO (CI)",         "Yes",              "Yes (limited data)","Yes"],
    ["Permanent support","NO (CI)",         "Yes",              "Unreliable LT",     "Yes (PP layer)"],
    ["Long-term data",   "5 yr (growing)",  "Extensive",        "Mixed RCT results", "Moderate"],
]

# Header row
hx = 0.3
for i, (hdr, hw, hcol) in enumerate(zip(headers, col_w, header_colors)):
    add_rect(s, hx, 1.28, hw - 0.04, 0.52, fill_color=hcol)
    add_tb(s, hx+0.08, 1.30, hw-0.16, 0.48, hdr, size=11, bold=True,
           color=WHITE, align=PP_ALIGN.CENTER, wrap=True,
           margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)
    hx += hw

# Data rows
row_y = 1.82
for ri, row in enumerate(rows):
    bg = WHITE if ri % 2 == 0 else RGBColor(0xEE, 0xF3, 0xFA)
    rx = 0.3
    for ci, (cell, cw) in enumerate(zip(row, col_w)):
        add_rect(s, rx, row_y, cw - 0.04, 0.56, fill_color=bg,
                 line_color=RGBColor(0xD0,0xD8,0xE8), line_width=Pt(0.5))
        cell_color = DARK_TEXT
        if ci == 1 and cell in ["NO (CI)", "Low – resorbs", "High", "Rapid + strong"]:
            cell_color = MID_BLUE
        if cell in ["NO (CI)", "Avoid", "Biofilm risk"]:
            cell_color = RED
        add_tb(s, rx+0.10, row_y+0.06, cw-0.22, 0.44, cell, size=11,
               color=cell_color, bold=(ci==0), align=PP_ALIGN.CENTER,
               wrap=True, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)
        rx += cw
    row_y += 0.58

# note
add_tb(s, 0.35, 6.80, 12.6, 0.28,
       "* CI = Contraindication per manufacturer labelling.  LT = long term.  Panel discussion: which mesh for which patient?",
       size=10, color=MID_TEXT, italic=True, margin_top=0)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 11 — TECHNICAL TIPS & PLACEMENT PRINCIPLES
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, LIGHT_GREY)
top_bar(s, "Technical Principles — Placing Phasix Mesh", subtitle="Plane Selection · Fixation · Orientation · Phasix ST vs Standard")
footer(s)

# Left column
add_rect(s, 0.35, 1.28, 5.9, 5.72, fill_color=WHITE,
         line_color=RGBColor(0xCC,0xD8,0xEC), line_width=Pt(1))
add_rect(s, 0.35, 1.28, 5.9, 0.40, fill_color=DARK_NAVY)
add_tb(s, 0.50, 1.30, 5.7, 0.36, "STANDARD PHASIX — PLACEMENT TIPS", size=12,
       bold=True, color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)

tips_left = [
    ("Preferred plane", "Retromuscular (Rives-Stoppa / TAPP) — best tissue coverage, lowest SSI exposure"),
    ("Overlap", "Minimum 3-5 cm overlap beyond fascial defect edge in all directions"),
    ("Fixation", "Absorbable tacks or sutures — non-permanent fixation preferred given mesh resorbs"),
    ("Orientation", "No specific orientation required for standard Phasix (no coating)"),
    ("Drain", "Closed-suction drain over mesh — reduces seroma in retromuscular plane"),
    ("Size selection", "Available up to 50×50 cm — choose generously; can be trimmed intraoperatively"),
    ("Closure", "Always achieve fascial closure — Phasix is NOT a bridging device"),
    ("Laparoscopic", "EU MDR data still evolving — discuss with team / ethics board pre-operatively"),
]
ty = 1.78
for key, val in tips_left:
    add_rect(s, 0.38, ty, 5.84, 0.60, fill_color=RGBColor(0xF0,0xF4,0xFB))
    add_tb(s, 0.50, ty+0.04, 1.65, 0.50, key+":", size=10.5, bold=True,
           color=MID_BLUE, margin_top=0, margin_bottom=0)
    add_tb(s, 2.20, ty+0.04, 3.95, 0.54, val, size=10.5, color=DARK_TEXT,
           wrap=True, margin_top=0, margin_bottom=0)
    ty += 0.64

# Right column — Phasix ST
add_rect(s, 6.55, 1.28, 6.45, 5.72, fill_color=WHITE,
         line_color=RGBColor(0xCC,0xD8,0xEC), line_width=Pt(1))
add_rect(s, 6.55, 1.28, 6.45, 0.40, fill_color=TEAL)
add_tb(s, 6.70, 1.30, 6.2, 0.36, "PHASIX™ ST — SUTUREABLE + ANTI-ADHESION", size=12,
       bold=True, color=WHITE, margin_top=0, margin_bottom=0, v_anchor=MSO_ANCHOR.MIDDLE)

add_tb(s, 6.70, 1.75, 6.2, 0.38,
       "Phasix ST = P4HB scaffold + ePTFE anti-adhesion barrier coating on one side",
       size=11.5, bold=True, color=DARK_NAVY, wrap=True, margin_left=0.05, margin_top=0)

st_tips = [
    ("Indication", "Intraperitoneal (IPOM) or sublay where visceral contact is anticipated"),
    ("Orientation CRITICAL", "Coated ePTFE side MUST face bowel / sensitive organs. NEVER reverse."),
    ("Sutureability", "Can be sutured — useful for complex reconstructions needing precise fixation"),
    ("Hiatal use", "Specifically indicated for hiatal hernia reinforcement"),
    ("Cancer proximity", "NOT for use near existing or excised malignancy — formal safety warning"),
    ("Contamination", "Some evidence for CDC III use; CDC IV data more limited than standard Phasix"),
    ("Antibiotic warning", "Same manufacturing antibiotic exposure as standard Phasix — check allergy status"),
]
sty = 2.22
for key, val in st_tips:
    add_rect(s, 6.58, sty, 6.38, 0.62, fill_color=RGBColor(0xF0,0xFB,0xF9))
    add_tb(s, 6.70, sty+0.04, 1.65, 0.52, key+":", size=10.5, bold=True,
           color=TEAL, margin_top=0, margin_bottom=0)
    add_tb(s, 8.40, sty+0.04, 4.4, 0.56, val, size=10.5, color=DARK_TEXT,
           wrap=True, margin_top=0, margin_bottom=0)
    sty += 0.66

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 12 — TAKE-HOME MESSAGES & CONSENSUS
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, DARK_NAVY)
add_rect(s, 0, 0, 13.333, 0.06, fill_color=TEAL)  # thin top stripe

add_tb(s, 0.5, 0.18, 12.0, 0.80,
       "Panel Consensus — Take-Home Messages",
       size=30, bold=True, color=WHITE, align=PP_ALIGN.LEFT)
add_tb(s, 0.5, 1.00, 12.0, 0.36,
       "What every surgeon should leave this session knowing about Phasix mesh",
       size=15, color=TEAL, align=PP_ALIGN.LEFT)

add_rect(s, 0.4, 1.42, 12.55, 0.04, fill_color=TEAL)

messages = [
    ("1", "Phasix is a time-limited scaffold — not a permanent implant. The body must do the final work after 12-18 months."),
    ("2", "The contaminated field is where bioresorbable mesh earns its place. Evidence supports use in Grade 3 VHWG — and cautiously in Grade 4."),
    ("3", "The formal contraindication is clear: NEVER use where permanent wound/organ support is the only structural element (bridging repair)."),
    ("4", "High-risk patients — obese, immunosuppressed, prior mesh failure — may benefit most from avoiding a permanent foreign body."),
    ("5", "Prophylactic use is a growing indication. 2025 data supports it, but patient selection and shared decision-making are essential."),
    ("6", "The right question is not 'Is Phasix good?' — the question is 'Is this the right patient, the right defect, and the right plane?'"),
]
my = 1.58
for num, msg in messages:
    add_rect(s, 0.40, my, 12.55, 0.78, fill_color=RGBColor(0x12, 0x3B, 0x6E))
    add_rect(s, 0.40, my, 0.52, 0.78, fill_color=TEAL)
    add_tb(s, 0.41, my+0.14, 0.50, 0.50, num, size=18, bold=True,
           color=DARK_NAVY, align=PP_ALIGN.CENTER, v_anchor=MSO_ANCHOR.MIDDLE,
           margin_top=0, margin_bottom=0)
    add_tb(s, 1.02, my+0.10, 11.8, 0.58, msg, size=13, color=WHITE,
           wrap=True, margin_left=0.05, margin_top=0.04)
    my += 0.84

footer(s, "Panel Discussion | Use of Phasix Mesh in Surgery | 2026")

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 13 — Q&A / CLOSING
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank_layout)
slide_bg(s, DARK_NAVY)
add_rect(s, 0, 0, 13.333, 0.06, fill_color=ORANGE)

# decorative right block
add_rect(s, 9.5, 0, 3.833, 7.5, fill_color=RGBColor(0x12, 0x3B, 0x6E))
add_rect(s, 11.2, 0, 2.133, 7.5, fill_color=RGBColor(0x17, 0x4E, 0x8A))
add_rect(s, 9.5, 0, 0.14, 7.5, fill_color=ORANGE)

add_tb(s, 0.6, 1.2, 8.5, 1.4,
       "Questions & Discussion",
       size=40, bold=True, color=WHITE, align=PP_ALIGN.LEFT)
add_tb(s, 0.6, 2.7, 8.5, 0.50,
       "The floor is open — one question per person, directed to any panelist",
       size=16, color=TEAL, align=PP_ALIGN.LEFT)
add_rect(s, 0.6, 3.32, 7.5, 0.04, fill_color=TEAL)

provocations = [
    "Has any panelist had a Phasix failure? What happened and what did you learn?",
    "If this were your family member on the table — which mesh would you choose?",
    "In 10 years, will bioresorbable mesh replace permanent synthetic as standard of care?",
    "What is the one patient you would never use Phasix for, no matter what?",
]
pq = 3.50
for q in provocations:
    add_tb(s, 0.6, pq, 8.6, 0.48, "Q  " + q, size=13,
           color=RGBColor(0xCC, 0xE0, 0xFF), wrap=True,
           margin_left=0.05, margin_top=0.02)
    add_rect(s, 0.6, pq+0.46, 7.5, 0.025, fill_color=RGBColor(0x25, 0x50, 0x80))
    pq += 0.54

add_tb(s, 0.6, 5.80, 8.5, 0.40,
       "Thank you to our distinguished panelists and to this outstanding audience.",
       size=13, color=RGBColor(0xAA, 0xC4, 0xDF), italic=True, align=PP_ALIGN.LEFT)

add_tb(s, 9.7, 3.0, 3.2, 0.45, "PHASIX™ MESH", size=20, bold=True,
       color=TEAL, align=PP_ALIGN.CENTER)
add_tb(s, 9.7, 3.55, 3.2, 0.35, "Natural · Not Permanent", size=12,
       color=RGBColor(0xAA, 0xC4, 0xDF), align=PP_ALIGN.CENTER)
add_tb(s, 9.7, 3.95, 3.2, 0.35, "Proven Results", size=12,
       color=RGBColor(0xAA, 0xC4, 0xDF), align=PP_ALIGN.CENTER)
add_tb(s, 9.7, 4.50, 3.2, 0.35, "P4HB Bioresorbable", size=11,
       color=RGBColor(0x88, 0xAA, 0xCC), align=PP_ALIGN.CENTER)
add_tb(s, 9.7, 4.90, 3.2, 0.35, "12-18 Month Scaffold", size=11,
       color=RGBColor(0x88, 0xAA, 0xCC), align=PP_ALIGN.CENTER)
add_tb(s, 9.7, 5.30, 3.2, 0.35, "Panel Discussion 2026", size=11,
       color=RGBColor(0x88, 0xAA, 0xCC), align=PP_ALIGN.CENTER)

footer(s, "Panel Discussion | Use of Phasix Mesh in Surgery | 2026")

# ════════════════════════════════════════════════════════════════════════════
# SAVE
# ════════════════════════════════════════════════════════════════════════════
out_path = "/tmp/workspace/phasix-panel/Phasix_Mesh_Panel_Discussion.pptx"
buf = BytesIO()
prs.save(buf)
with open(out_path, "wb") as f:
    f.write(buf.getvalue())

print(f"Saved: {out_path}")
print(f"Slides: {len(prs.slides)}")

Running Command

cd /tmp/workspace/phasix-panel && python build_ppt.py 2>&1

Your presentation is ready. Here is the download link:

Phasix Mesh Panel Discussion

Presentation · PPTX

What's inside — 13 slides:

#	Slide	Content
1	Title Slide	Professional cover with Phasix branding, navy/teal design
2	Panel Agenda	Full 8-segment timeline with duration bars
3	What is Phasix?	P4HB properties table + 4 key clinical statistics with colour-coded stat cards
4	Indications & Contraindications	Green/red/orange three-panel layout with all official warnings
5	Case 1: Contaminated Field	Case card + evidence snapshot (5-yr trial data) + panel discussion points
6	Case 2: High-Risk Patient	Case card + 4 risk factor boxes (BMI, steroids, Crohn's, prior mesh) + panel prompts
7	Case 3: Prophylactic Use	Case card + 3-column debate (For / Against / Expert considerations)
8	Case 4: Pregnancy After AWR	Case card + 2026 literature highlight + 6-row Q&A grid
9	Contraindications Rapid-Fire	All 5 scenarios with numbered cards and panel context verdicts
10	Phasix vs. Alternatives	Full comparison table: P4HB vs. PP/PVDF vs. Biological vs. Composite
11	Technical Principles	Standard Phasix placement tips + Phasix ST orientation warnings
12	Take-Home Messages	6 consensus statements on dark navy with teal accent cards
13	Q&A / Closing	Provocative final questions, closing acknowledgement

The design uses a consistent dark navy, teal, and orange palette with clinical case cards in warm cream, and all slides include a footer with the session title.

This is a shared conversation. Sign in to Orris to start your own chat.