PS News: Issue 12, May 2013

Issue 12, May 2013

Headline News

We have moved!!

The Division of Plastic & Reconstructive Surgery has moved from the Banting Institute to its new home on the 5th floor of the Stewart Building, 149 College Street, Room 508.  Phone and Fax remain unchanged.

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Chair’s Column

Christopher-Forrest
Dr. Christopher R. Forrest
Chair
Division of Plastic and Reconstructive Surgery

It certainly has been a long time in coming but I am thrilled to see the daffodils and crocus flowers peeking through the brown haze that makes up the March landscape in these parts. But it is the removal of the snow fence around King’s College Circle adjacent to the UofT Medical School Building that really signals the end of the white stuff.

Spring always reminds me of that song “Changes” by sexagenarian rocker David Bowie from his 1971 album “Hunky Dory” that he has sung a bazillion times. “C-c-c-changes, turn and face the strain….” Something about the green grass and smell of forsythia erasing the last vestiges of winter that makes me think about the passage of time, renewal and regeneration. All part of the cycle of life.

So what will the spring of 2013 bring to our division? We have just passed our Royal College review with flying colors. That is a pretty big deal. It means that for the most part, we are doing a fine job in producing high quality Plastic and Reconstructive Surgeons. Thanks again to Dr. Mitch Brown, Kathy Pavlovic and the rest of the Residency Program Committee who have worked very hard to make it all happen. We are an impressive division on paper. 47 staff, 26 residents and 22 clinical and research fellows at last count, not to include the essential administrative staff that provide ground support and the members of the allied health specialties that allow us to do what we do. Big geography and there is no area of clinical weakness. So why should we change anything? For those of you who follow the PGA tour, it is a familiar story when someone wins a major and the next day changes their clubs, gets a new ball sponsor and starts tinkering with their swing never to be seen again on the leaderboard! And this is what got them the win in the first place (hey, can anyone say Mike Weir?)

Golfing exploits aside, there is a great opportunity from analyzing one’s success and seeing what can be done to make things better. A chance to enhance and evolve, figure out what is working and what doesn’t. David Bowie was (and probably still is) a master of change. He had a talent to see the next thing that was coming.

So that brings me back to my Division. Obviously, I am not suggesting that we tinker with success and institute radical changes. But in the reflection that passes after the relief of passing the Royal College review, I believe that there are a bunch of things that we can work on. We can work on being better surgeons, we can work on being better teachers and we can do things that advance and strengthen the specialty. In the words of another well-known Bowie song, “we can be heroes”. Perhaps that would be a good start.

And so, stay tuned…

Research Director’s Report

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Dr. Joel Fish
Research Director

Two out : Three In !

Each year I take a moment to reflect on the research accomplishments of our residents and I am in awe of what is accomplished with so little resource. This year’s Resident Research Day was held on February 22, 2013 and the quality of papers presented by our residents was outstanding. Dr. Michael Neumeister commented that this single day event is of such high quality it could almost be considered a separate meeting! Many of our faculty that generously donate resources of time and money to help the residents reach their goal of developing an idea and presenting something original attended the day and also commented on the high level of achievement that was present. Our Division fosters the importance of research as it relates to teaching residents how to think a bit more critically in an area of interest. This training is invaluable and over the years the feedback from our graduates in terms of having been through this process, is very positive.

Two out! This refers to the fact the Dr. Siba Haykal and Dr. Jennica Platt are completing their research degrees and will re-enter the clinical stream in July! Dr. Haykal is in the final stages of defending her PhD under the guidance of Dr. Stefan Hofer and Dr. Tom Waddell. She has worked incredibly hard to finish in a four year time frame (the average PhD at the University of Toronto is 5.5 years) and her success in the lab as measured by publications, presentations and awards has been incredible. We look forward to having Siba back from the lab in the clinical setting. I have always told residents that a Master’s degree is an accomplishment that allows for deep study which may or may not affect your future, but, a PhD has the capacity to change you forever due to the depth of study. Congratulations to Siba for taking on this enormous project! Dr Jennica Platt under the supervision of Dr Toni Zhong and Dr Nancy Baxter is also completing her Masters degree and the time has just flown by. Jennica applied to our program seeking the Surgeon Scientist Program and has been incredibly supportive of other students that are interested in the SSP. She has contributed to our understanding of how we deliver care for post breast cancer reconstruction that has set the stage for future studies, addressing at a high level, how we can improve the current rates of reconstruction in our province.

Three in! This refers to the fact that we still have three residents enrolled in the Surgeon Scientist Program. Dr. Katie Armstrong will be under the supervision of Dr. John Semple investigating the role of new innovative technology that allows us to deliver health care! Her enthusiasm is infectious. Dr. Joseph Catapano will be working in Dr. Greg Borschel’s laboratory further investigating nerve regeneration and will be working alongside Dr. Mike Hendry who is well on his way with experiments that have investigated the mechanism(s) responsible for nerve regeneration. It has been a long time (not as bad as the Leafs in the playoffs) since we have had two of our trainees working in the same laboratory at the same time!

Interestingly, every resident in our current PGY2 year seriously considered entering the SSP this year. This led to discussions at the Residency Program Committee about how we would handle a mass exodus. More importantly it says something about the residents in our program and how they value this experience. Our faculty are highly supportive of students gaining this experience and having this as a potential problem is a good thing. If everyone had exited the clinical stream into the lab we could have a two day annual research meeting, required a new research committee to follow everyone, developed a wing of the university to fit them all in, and wrote to the government to ensure we can get them all academic appointments! I would have needed to change the title of this article… dream on!

Program Director’s Report

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Dr. Mitch Brown
Program Director

Since my last report, the major focus of the division has been on the external review of our training program by the Royal College of Physicians and Surgeons of Canada. This requirement for all programs in Canada takes place every six years and is designed to insure that the training program is meeting the goals and objectives of training, as laid out by the College as well as the Specialty Committee of Plastic Surgery.

The on site visit took place on April 8 and involved a series of meetings between the external reviewer and our residents and faculty. The final report from the College will be delivered in several months, but we have been given verbal notification of “approval with next review as scheduled in 2019”. The amount of effort required to prepare for this review was extensive and involved a major commitment from multiple people. I want to thank our acting Chair, Dr. Chris R. Forrest, the Residency Program Committee, rotation chiefs and those faculty involved in running the various educational components of our program for their efforts not only in delivering the educational curriculum, but for their hard work in preparing for the review. It is important to recognize the residents who were inconvenienced on multiple occasions for required meetings with the Department of Surgery, and whose input was important in allowing for a successful review. Finally, most of the leg work for the review process was carried out by our program administrator Kathy Pavlovic and she should be given a huge thank you from the entire division.

In January. our program committee met to select the new residents for the upcoming year. We had a very successful match and I am pleased to welcome five new residents that will enter our program this July.

 Sebastian-Vrouwe
Sebastian Vrouwe
University of Alberta
Jessica-Shih
Jessica Shih
University of Toronto
Jana-Dengler
Jana Dengler
Maryam-Saheb-Al-Zamani
Maryam Saheb-Al-Zamani
Washington University, St. Louis
Natalia-Ziolkowski
Natalia Ziolkowski
University of Warsaw
 

The new residents will participate this July in the Department of Surgery Surgical Boot Camp. This two week course for all surgical trainees will provide the new residents with an opportunity to learn core surgical skills in a “classroom” environment prior to joining the clinical stream. This move towards competency based training represents an important trend in surgical education, and will most certainly be expanded into all levels of training over the next several years.

As five new residents join our program, we get ready for our annual graduation to celebrate the accomplishments of our graduating residents. This year we will see six residents graduate and move on to either independent practice or further fellowship training.

 karen-cross  Kunaal-Jindal  Roberto-Tutino
Karen Cross

Kunaal Jindal

Dr. Kunaal Jindal will begin a 12 month fellowship position in Atlanta with Dr. Mark Codner.

Roberto Tutino

Dr. Tutino will be begin a fellowship in Melbourne, Australia doing general plastics with Dr. Howard Webster and Dr. Brian Mendelson.  Followingn this, he will be going to Paris, France to complete a fellowship in brachial plexus and hand with Dr. Christoph Oberlin.

 Jing-Zhang  Ron-Somogyi  Saad-Al-Qahtani

Jing Zhang

Dr. Zhang will begin a 6 month fellowship on July 1, 2013 in the Hand Program at the Toronto Western Hospital and then complete another 6 month fellowship in Microsurgery at the University of Manitoba.

Ron Somogyi

Dr. Somogyi will begin a 12 month fellowship in breast reconstruction and general plastics in Melbourne Australia at the  Peter Macallam Cancer Centre and Melbourne Institute of Plastic Surgery.

Saad Al-Qahtani

Dr. Al-Qahtani will begin a 12 month microsurgery fellowship with Dr. Stefan Hofer at the Toronto General Hospital.

The division looks forward to following their careers and having them join the ranks of University of Toronto alumni.

I wish everyone a fantastic summer filled with some rest and relaxation and spending time doing the things that we most enjoy. Speak to you in the fall.

Mitch

Fellowship Update

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Dr. Toni Zhong
Fellowship Director

On behalf of the Division of Plastic and Reconstructive Surgery I would like to extend our most sincere gratitude to our fellows for helping us achieve another fantastic year. Both our clinical and research fellows have been exceptionally productive this year. In addition to our fellows having presented their research from our division in major national and international meetings, we have over 10 publications from our fellows in high impact peer-reviewed journals such as Plastic Reconstructive Surgery, Annals of Surgical Oncology, Journal of Burn Care and Research, Burns, Journal of Plastic Reconstructive and Aesthetic Surgery, and Journal of Craniofacial Surgery. To celebrate the end of the fellowship year, we hope to see all our fellows and their spouses at our end of the year Graduation Gala Dinner where we can formally acknowledge and thank them for all their contributions to our division.

www.UofTPlasticSurgery.ca

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www.uoftplasticsurgery.ca
Kathy Pavlovic

New Launch

The Division of Plastic and Reconstructive Surgery is proud to launch its own Facebook Group. This is a closed/private group for the Division whereby all faculty, residents, admins, and alumni can use this as a place to post photos of events, announcements, keep in touch, etc.

Follow us on social media:

facebook-32x32 Group for U of T Plastic and Reconstructive Surgery

twitter-32x32 @UofTPRS

Growing interest in our website from launch of NEW E-News

Through the use of Google Analytics, the program which monitors our website traffic, utilization and time spent on any given page of the site, as well as Mailchimp, the program which is used to create and send our new E-Newsletter directly linked to our website, we have captured continued growth of this website. Of note, during the period of April 7th to May 7th, 2013, we had a total of 5,323 visits in that one month alone. There were 14,591 pageviews and 2.74 pages viewed/visit. Visitors spent on average 1.44 minutes on our website and 60.27% of all visits were new visits.  There were 3,691 unique visits from 94 countries.

The chart below demonstrates the top locations that viewed our website and newsletter:

Top Locations Opens
canada
Canada
3,852
usa
USA
441
uk
United Kingdom
149
peru
Peru
155
india
India
62

For comments, suggestions or information about our website, please email Kathy Pavlovic at plastics.admin@utoronto.ca

Incoming Residents

Sebastian-Vrouwe Sebastian Vrouwe
Sebastian was born and raised in Edmonton and attended the University of Alberta for both his undergraduate degree in Biology and medical school. In his free time, he enjoys cooking, finding new restaurants, traveling, listening to live music and seeing films. He also makes time for cycling, basketball and more recently, golf. He is very excited to join Toronto’s Division of Plastic and Reconstructive Surgery and experience everything that the city has to offer!
Jessica-Shih Jessica Shih
Jessica is from Burlington, Ontario, and attended medical school at University of Toronto after finishing her Bachelor of Arts at Cornell University. Some of her interests include exploring new restaurants around town, playing sports such as badminton, squash, golf, and traveling.
Jana-Dengler Jana Dengler  
Jana was born in Stuttgart, Germany, and moved to Toronto at the age of 8. She completed her undergraduate studies in chemical engineering at Queen’s University, and went on to obtain a Master’s degree in cardiac tissue engineering at the University of Toronto. Jana’s graduate work inspired her to pursue medicine, also in Toronto. She enjoys spending her spare time outdoors – cycling, rock climbing, skiing, running, backcountry camping, scuba diving – you name it. She has a love for visual arts and enjoys the creative challenges of plastic surgery. Jana is thrilled to be starting her residency training in Toronto this summer!
Maryam-Saheb-Al-Zamani Maryam Saheb-Al-Zamani     
Maryam was born in Iran and moved to Toronto when she was 11 years old. Following completion of her undergraduate studies at University of Toronto, she decided to expand her horizons and moved south of the border to Saint Louis to complete medical school at Washington University. In her downtime, she unwinds by baking, trying new cuisines, and attending live performances. She is very excited to return to her true home and begin her training in plastic surgery at this world-renowned institution!
Natalia-Ziolkowski Natalia Ziolkowski
Natalia is thrilled to be joining the Division of Plastic and Reconstructive Surgery at the University of Toronto!Natalia was born and raised in Hamilton, ON where she completed a triple major in Commerce, Biology, and Psychology at McMaster University. From there she went to study medicine at the Medical University of Warsaw (English Division) in Warsaw, Poland. During her free time, Natalia enjoys hot yoga, running outdoors, and travelling. Natalia is excited to be coming back home to Canada after her studies abroad and is happy to be calling Toronto home!

Other Stories

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Congratulations to Dr. Jamil Ahmad

Our congratulations go out to Jamil Ahmad and his wife Agnete Lee Toest on the birth of their second son Christopher Frank, brother to Thomas.

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Congratulations to Dr. Joan Lipa

Congratulations to Joan Lipa and Adriaan Van Rensburg with the recent addition of  Renée Anne who was born on Oct 10th at 1pm weighing 6 pounds, 6 ounces.

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Congratulations to Drs. Snell & Ford

Congratulations to Drs Laura Snell and Derek Ford with the recent addition of Jonathan James Ford who arrived last Wednesday September 19th at 10:58am. Benjamin has a baby brother and the division has a potential recruit!

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Congratulations to Dr. Paul Carter

Dr. Paul Carter and his wife Elaine have welcomed a new baby girl, Anastasia on Saturday, March 2nd at 2:46 p.m. weighing 6 lbs, 8 oz. We wish Paul and his family all the very best in this exciting new journey.

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Congratulations to Dr. Rayisa Hontscharuk

Congratulations to Dr. Rayisa Hontscharuk on the birth of her second son Matthew William Gonsalves.  Matthew was born on April 24th weighing a healthy 7 lbs 15 oz.  We wish Rayisa and her family all the very best and look forward to her return after her one year maternity leave.

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Congratulations to Dr. Mike Hendry

We are pleased to announce that Dr. Mike Hendry and his wife Jess have welcomed a new baby boy, James Logan on Sunday, November 11th, 2012 after a mere 36 hours of labour! We wish Mike and his family all the very best in this exciting new journey.

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Congratulations to Dr. Dale Podolsky

Congratulations to Dr. Dale Podolsky and his fiancee Susan Feldman on their engagement!  Susan  works at Sickkids in the HR department and they have set their wedding date for August 25th, 2013!

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Congratulations to Dr. Matthew Murphy

Congratulations to Dr. Matthew Murphy on his marriage to Jennifer Schymick.  The wedding took place on Monday February 18, 2013 in Hawaii!

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Congratulations to Dr Joseph Catapano

Congratulations to Dr. Joseph Catapano and Dr. Ines Menjak who got married on September 8, 2012.

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Congratulations to Dr. Kunaal Jindal

Congratulations to Dr. Kunaal Jindal and Dr. Nina Lakhani who got married on September 8th, 2012.

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Congratulations to Dr Matthew McRae

Congratulations to  Dr. Matthew McRae & Natalie Babony who got married on September 29th, 2012.

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Still Waiting…

Dr. Roberto Tutino and fiancée Dr. Pamela An will be getting married sometime in 2013.

Project in East Africa

Since the project’s inception two years ago, we have conducted surveys of burn patients at two hospitals in Kenya and over 30 in-depth interviews with parents of children with severe burn injuries hospitalized there. To the best of our knowledge, ours is the first study that includes a qualitative component interviewing patients at hospital to understand the event as it happens and how we can best develop prevention strategies that will be successful. The data have been invaluable in understanding the demographics of patients who are getting burned and also in understanding the differences between urban and rural patients.

In the Fall of 2012, Drs. Kasrai and Yekta attended the International Society for Burn Injuries meeting in Edinburgh. The meeting was a perfect location to get together with all our international partners and forge further collaborations. These collaborations include one with Dr. Saidur Mashreky, the Director of Public Health and Injury Prevention Ddivision of the Centre for Injury Prevention and Research in Bangladesh. Dr. Mashreky has been involved in the implementation of burn injury prevention research programmes for a number of years and we hope to expand this work to Kenya. We also met with the Global Alliance for Clean Cookstoves and the World Health Organization and are now part of two working groups that will develop universal data repository for burn patients at clinics and hospitals across the world to collect comparable data that can be used in improving care for burn patients and in developing burn prevention programmes.

From the 26th of November to the 3rd of December, Dr. Yekta was invited to Nepal and Bangladesh with the Interburns team to teach 6 training courses, training 93 candidates in Essential Burn Care and 40 candidates as instructors to deliver EBC more widely throughout each country. In each country, the three days of training began with an EBC course run by the international team, followed by a training of trainers for selected participants the following day, and concluding with an EBC run by the local faculty and instructors.

We hope to start our household surveillance collaboration with the Centers of Disease Control and Prevention in Kenya by early 2014 to gather data on the true incidence of burn injuries. At the same time, we will be piloting burn prevention programmes in the Kibera slum in Nairobi and Nakuru in the Rift Valley Region.

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Hospital Updates

St. Joseph Health Centre

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Dr. Craig Fielding

The last year at St. Joseph’s has seen the completion of Dr. Leila Kasrai’s term as Chief of the service, and I would like to thank her for all the time she put into this task. We remain a four-surgeon service, with all members strongly committed to Post Graduate surgical training. The senior residents over the last year have been a pleasure to work with, and we continue to attract a large number of medical students for electives and selectives.

The Health Centre has opened its newest structure, the Our Lady of Mercy Wing, which is allowing some much-needed reshuffling of services. St Josephs’ patient base continues to expand, as the Lakeshore high-rise strip is developed, and our nearest main street, Roncesvalles, has become a great dining and music destination. Check it out!

University Health Network (UHN) – Toronto General Hospital

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Dr. Stefan Hofer

Staff

The Division of Plastic & Reconstructive Surgery, University Health Network has recruited a number of key individuals to start in the 2012 – 2013 academic year.

Dr. Steven J. McCabe MD, MSc has taken the position of Director of the Hand Program at the Toronto Western Hospital. His goals are to transform the Hand Program into a University wide collaborative group, to develop a program in hand transplantation, and to invigorate the academic activities of the Hand Program.

Dr. Anne O’Neill has been appointed and is beginning her clinical and research career as an Academic Plastic Surgeon following her successful completion of her microsurgery fellowship. She will start her basic research projects on VCA related topics from collaboration at the lab of Dr. Tom Waddell (Thoracic Surgery) and Dr. Cho Pang at the Hospital for Sick Children.

Kelly Metcalfe, RN, PhD has been cross-appointed to the Department of Surgery, Division of Plastic and Reconstructive Surgery at the University of Toronto. She is the Co-Director of Clinical Research in the Breast Restoration Program along with Dr. Toni Zhong.

We have also hired Ms. Shaghayegh Bagher as the biostatistician and Ms. Natalie Causarano as a Clinical Research Coordinator for the Breast Restoration Program.

We are currently in the process of recruiting a new Hand Surgeon to the Hand Program at the Toronto Western Hospital.

Research Grant Funding Update

We are very pleased to report the receipt of a second operating grant from the Canadian Institute of Health Research (CIHR) for the project entitled ‘Development of a decision support tool in post mastectomy breast reconstruction surgery’ PI: Stefan OP Hofer and Kelly Metcalfe, David McCready and Toni Zhong. (CIHR) $142,000, 2012 – 2014.

Dr. Toni Zhong is pleased to announce the recruitment of the Tom Baker Cancer Centre in Calgary with Dr. Claire Temple-Oberle as the site PI for the CBCF funded MCCAT Trial entitled ‘The use of human acellular dermal matrix in one-stage implant breast reconstruction: A multicenter, randomized, controlled trial’.

Dr. Jennica Platt and supervisor Dr. Toni Zhong received a Fellowship Grant from the Physicians Services Incorporated Foundation (PSI) for an innovative new project entitled ‘Breast Reconstruction Decision Support Workshop Pilot RCT’ $19,000, 2012 – 2013.

Dr. Toni Zhong is supervising Dr. Amanda Roberts (PYG5) in the Division of General Surgery on a research project entitled “Healthcare Utilization during the Survivorship Period: A Population-Based Study of Mastectomy and Breast Reconstruction in Ontario”, that was $143,000, 2013-2015 that received a two-year Research Fellowship Grant from the Canadian Breast Cancer Foundation.

Sponsored International Meetings

Drs. Toni Zhong and Fiona Webster in the Department of Family and Community Medicine at the University of Toronto successfully hosted a Canadian Institute of Health Research (CIHR) funded international research planning meeting entitled “Understanding Bangladeshi women’s experiences of humanitarian surgical missions” on October 4-5, 2012 at the University of Toronto. The meeting brought together key international stakeholders to identify major themes, formulate relevant research questions, and develop appropriate study designs to objectively measure Patient Reported Outcomes for humanitarian surgical missions.

Sponsored National Meetings

All members of the Division of Plastic & Reconstructive Surgery at UHN supported another successful National Breast Reconstruction Awareness (BRA) Day in collaboration with colleagues throughout the country.

Publications and Presentations

During the past 2012 – 2013 academic year, division members have published [16] peer-reviewed papers, presented [24] scientific papers and participated in [8] invited lectures.

Dr. Hofer was an invited speaker at the Mayo Clinics Reconstructive Symposium, the Austrian Society of Plastic Surgery, the Swiss Breast Reconstruction Group, American Society for Reconstructive Microsurgery Annual Meeting, IPRAS Meeting in Chile and the International Breast Surgery Workshop, Rome, Italy.

Dr. Zhong was invited to be a member on the ASPS – PSEF Scientific Board Grant Review Committee for 2012-13.

Other

Dr. Stefan Hofer was appointed to a second and final 3-year term to serve as the Editor-in-Chief for the Journal of Plastic, Reconstructive and Aesthetic Surgery (2013-2015) by the British Association of Plastic and Reconstructive Surgery.

Awards

Dr. Toni Zhong received a 3-year Career Development Award from the American Society of Clinical Oncology (ASCO) – Conquer Cancer Foundation (2012 – 2015).

Promotions

Dr. Stefan Hofer was promoted to Full Professor in the Division of Plastic and Reconstructive Surgery, Department of Surgery at the University of Toronto.

Dr. Dimitri Anastakis was promoted to Vice-Dean of Continuing Education and Professional Development in the Faculty of Medicine,  at the University of Toronto.

Surgeon – Scientist Plastic Surgery Residents

We are extremely proud of our two Surgeon – Scientist Plastic Surgery Residents that have received the highest level of recognition for their graduate work.

Jennica Platt in the MSc Surgeon – Scientist Program has received funding from CBCF, CIHR and PSIF and will be defending her thesis project entitled ‘Geographic access to breast reconstruction in Ontario and the influence of physician availability’.

Siba Haykal in the PhD Surgeon – Scientist Program will defend her PhD thesis on Tracheal Allotransplantation on May 17th, 2013.

Hospital for Sick Children

Christopher-Forrest
Dr. Christopher R. Forrest

It has been a busy few months for Division members at the Hospital for Sick Children!

The Division was saddened by the passing of Dr. Hugh G. Thomson, MD, MSc, FRCSC, (January 3, 1930 – November 18th 2012). As has been acknowledged, Dr. “T” was a huge influence on the division, having been a staff member at the Hospital for Sick Children for 43 years (1960-2003) and a mentor/teacher to all but one of its current staff. He will be missed.

Congratulations are in order for Dr. Greg Borschel. Dr. Borschel was promoted to Associate Professor in the Department of Surgery in this past year’s review.

karen-wongFollowing an extensive search, the Division is delighted to announce the appointment of a new staff member. Dr. Karen Wong will be joining the division in the summer of 2013 after completing research fellowships at the Hospital for Sick Children and a clinical fellowship in Taipei under the supervision of former Toronto fellows Dr. Fu Chan Wei and Dr. Yu Ray Chen. Dr. Wong received her MD from the University of Toronto in 2006 and successfully completed her residency training in Plastic and Reconstructive Surgery in Toronto in 2011. She has been developing a Patient Reported Outcome Measure in cleft care (CLEFT-Q) under the supervision of Dr. Ann Klassen (MacMaster) and Dr. Forrest and has recently transitioned into a PhD program. Her appointment will be as surgeon-scientist with a clinical focus on cleft and microsurgery. We are thrilled to have one of our own join our group. Welcome Karen!

Dr. Christopher R. Forrest underwent a 10 year review of his leadership of the division in November 2012 and was successfully re-appointed for a third 5-year term. Dr. Richard Hopper (University of Washington, Seattle) was the external reviewer and described the division as having an “an unparalleled international reputation”. The division members are seen celebrating the event with the ritual drinking shots from the communal hockey stick at the annual Christmas party.

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The annual University of Toronto Transplant Day was held on December 17th, 2012 with division members Drs. Ron Zuker and Greg Borschel taking front and center stage by organizing a half-day symposium on Composite Vascularized Allotransplantation (CVA). This was a spectacular event with the highlight being a lecture by Visiting Guest Speaker Dr. Bohdan Pomahac from Boston. Dr. Pomahac led the team at the Brigham and Women’s Hospital, Harvard Medical School in 3 CVA face transplants and shared his experience with the audience. Presentations by our own Dr. Blake Murphy and Dr. Siba Haykel were very well received. The following day, Dr. Pomahac held a workshop at the Surgical Skills Centre, Mount Sinai Hospital for a select few and performed cadaver dissections for CVA face procurement. I am proud to say that our Toronto team lead by Dr. Ron Zuker has made significant progress in establishing a CVA program for the province.

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Drs. Murphy (left) and Haykel (right) at the Annual University of Toronto Transplant Day.

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Drs. Stefan Hofer, Greg Borschel, Bohdan Pomohac and Ron Zuker (left to right)at the Surgical Skills Centre workshop following the UoT Transplant Day, December 2012

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The 9th Annual Lindsay Thomson Day was held on April 5th, 2013 at the University Club and Dr. John B. Mulliken, Professor of Surgery, Harvard Medical School was the 2013 Vale Lecturer. The event was a spectacular showcase of the scope of practice for our division and included lectures from Dr. Sarah Bowdin (Genetics), Dr. Philip John (Interventional Radiology), Dr. Marla Bigel (Neuropsychology) and Charis Kelly (CNP – Burns) in addition to our own staff members. Dr. Mulliken’s keynote lecture on the management of bilateral cleft lip was masterclass and the highlight of the event.

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Drs. Joel Fish, John Phillips, Chris R. Forrest, Visiting Vale Lecturer Dr. John Mulliken, David Fisher, Ron Zuker, Howard Clarke and Philip John (Interventional Radiology) at the 2013 Lindsay Thomson Pediatric Plastic Surgery Symposium.

Dr. Joel Fish and members of the Burn Team had the enviable job of performing a site assessment and review of the Pediatric Burn Program in Hawaii last February. Yes, I said Hawaii. The review came at the request of Dr. David Cho, former Pediatric Plastic Surgery fellow who runs the Pediatric Burn Program in Hawaii. This was a very successful visit and an opportunity to assist and influence burn care outside the four walls of SickKids and also to create important linkages with other Pediatric Burn Programs. Although most of the week was spent intensively working, some time was found to pursue some of the pleasures that the island had to offer. In an unusual coincidence, requests to become honorary members of the SickKids Burn program have recently peaked.

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Burn Team members Lisa Lazarotto, Joel Fish, Charis Kelly and Jamil  with former fellow and Hawaii resident, Dr. David Cho.

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Dr. Greg Borschel was the focus of a recent spotlight article in the Plastic Surgery News acknowledging the importance of the Academic Scholar award supported by the American Association of Plastic Surgeons.

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The Division would like to acknowledge the assistance and huge amount of  work performed by its contingent of outstanding fellows during the past academic year. Dr. Erika Henkelman who graduated from SIU, Springfield, Illinois under the supervision of a UoT graduate, Dr. Mike Neumeister, will be continuing her quest for further pediatric fellowship training and will be spending a year in London, Ontario working with Dr. Damir Matic. Dr. Marc Swan (Oxford, UK)  will be returning to the UK to do additional fellowship training at Great Ormond Street Hospital in London. Dr. Sally Hynes (Vancouver, BC) has decided to pursue adventures in Switzerland accompanying her husband Jason who has taken a 3 year post in Geneva. Dr. Guy Watts (Perth, Australia) has accepted a 1-year Aesthetic Surgery Fellowship in the Big Apple. Dr. Mahsa Moghaddam (Mayo Clinic, Rochester, MN) has recently welcomed a son, Evan and will be spending the next year in Toronto, with her partner who is completing a 2-year Fellowship in Transplant at UHN. Dr. Udi Arad (Tel Aviv, Israel) is completing a fellowship in Breast Reconstruction at the UHN and will be returning home to Tel Aviv in the summer. Our division members would like to thank them for all of their hard work and efforts and to wish them well in their future careers.

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Drs Udi Arad, Gale Lim, Erika Henkelman, Mahsa Moghaddam, Marc Swan, Karen Wong, Sally Hynes (and Ali) and Guy Watts.

Toronto East General Hospital

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Dr. Linda Dvali

Our hospital is busy moving forward with its complete renovation. It promises to be a world-class facility aimed to continue to provide exemplary community care. We recently moved our minor surgery into the newly renovated space. This new space doubles our capacity with the addition of a second, fully-equipped room.

Our renovation also includes a state-of-the-art Education and Conference Multi-Media Centre, to be prominently located in the Ken and MarilynThomson Patient Care Centre. This centre will be equipped with the latest technology including advanced audio-visual and conferencing equipment to support our current and coming advances in education and provide an optimal learning environment.

Resident teaching continues to be a priority at our institution. Dr. Brett Beber was recently nominated for a Pairo teaching award. Congratulations Brett!

Dr. Linda Dvali will be participating in a Calgary Hand and Wrist Fracture Management workshop sponsored by the AO Foundation. Dr. Paul Binhammer is organizing this comprehensive workshop that will be held in Calgary on Tuesday May 28th just ahead of the Canadian Society of Plastic Surgery Meeting. We hope to see you there!

Finally Dr. Laura Tate is taking a lead role in working to establish a comprehensive program in post-bariatric body contouring surgery. Laura is organizing a trip to Pittsburgh to visit Dr. Peter Rubin’s practice in post bariatric body contouring June 11-13th. Those interested could email ltate@tegh.on.ca

Sunnybrook Health Sciences Centre

Paul Binhammer
Dr. Paul Binhammer

2012 brought new additions to our team and 2013 allowed some returns. We have been thrilled to have Dr Glyka Martou join us since the summer of 2012. She has taken over the practices of Drs Lipa and Snell while they were on maternity leave. Dr Snell had a beautiful baby boy, Jonathan, and Dr Lipa had a beautiful girl Rene. Drs Lipa and Snell have returned to clinical activities and so now we have a very active Breast and Oncology Reconstruction Program with three surgeons. Dr Amy Chesney is the fellow and has had a very busy clinical experience.

The Craniofacial Program has appreciated the efforts has appreciated the hard work of our Australian fellow, Dr. Sophie Ricketts. She has been an invaluable asset.

Women’s College Hospital

John Semple
Dr. John Semple

Excitement is in the air – as you read this, Women’s College is merely a few weeks from moving in to Phase 1 of its new home!

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Residents/Fellows

We said good-bye to the Brits (Loz and Andrew) and welcomed new residents Kunaal Jindal, Roberto Tutino and Kathryn Isaac and a brand new fellow, Tatiana Cypel.

Women with Altitude

Last August/September Dr. Semple led a brave team of climbers who made the trek up Mount Kilimanjaro raising over $75,000 for our new hospital.  Another successful part of this fund raiser was a hugely successful bake sale, aptly named “Cookies for Kilimanjaro” – it raised over $600 alone!  The Women’s with Altitude team included WCH Board Chair, Jane Pepino, Dr. John Semple, WCH Board Member Lesley Byrne, and Chief of Communications and Marketing, Lili Shalev Shawn.  What an incredible journey they had!

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Mobile Health Care

Dr. S. continues with his mobile app marketing and participated in a Mobile Health Care Summit in January 2013.

Grants

Impact of Radiation Therapy on the Lymphatic Circulatory System: Relevance to Breast Cancer Related Lymphedema.  Johnston M, Semple JL: Canadian Breast Cancer Foundation – Ontario Region Chapter.  ($430,631 2011 – 2014)

The use of human acellular dermal matrix in one-stage implant breast reconstruction: A multicenter, randomized, controlled trial”.  Zhong T, Baxter N, Hofer S, Brown M, Beber B, Semple J: Canadian Breast Cancer Foundation – Ontario Region Research Project Grant Program Fall 2011.  ($368,449 2011 – 2014)

Second annual BRA Day offers education and support to breast cancer survivors (October 2012)

Rosemarie Shannon’s voice trembled as she spoke to a crowd of more than 300 people about her battle with breast cancer. A healthy and active mother of two, Shannon was shocked by her diagnosis. Mastectomy (breast removal) and months of chemo that followed left her feeling like she didn’t have control over her life, she said. Longing to feel her old self again, she opted for breast reconstruction surgery. “Finally, I felt in control again,” said Shannon. “It gave me peace of mind that I did everything to fight this disease.”  Shannon shared her moving and inspiring story at the second annual national Breast Reconstruction Awareness Day (BRA Day) on Oct. 17 at the Toronto Reference Library.

Now in its second year, BRA Day promotes awareness, education and access for women considering breast reconstruction post-mastectomy.  Approximately 350 people attended and the event featured nine speakers including Women’s College Hospital’s (WCH) Dr. Mitchell Brown, founder of BRA Day, as well as Dr. John Semple, WCH’s chief of surgery, and registered nurse Helen Mark.

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CBCF Run for the Cure (Sept 2012)

There were several runners from our department running this year including Dr. Semple, Brown and several residents including  Heather Baltzer, Jennica Platt, Dale Podolsky and Matthew Plant.

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University of Toronto Dean’s Report 2011-2012

Dr. Semple was recognized for his innovative help in creating an app with a company called QoC (Quality of Care) so he can assess patients after surgery with a hand held tablet from any location.  Patients can securely and confidentially answer questions about their recovery and send him photos of their incision via their own mobile device, effectively receiving a wireless house call.

Education Program in Aesthetic Plastic Surgery –
Women’s College Hospital

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Dr. Jamil Ahmad

In July 2012, the Division decided to restructure the aesthetic rotation and the resident cosmetic clinic opened at Women’s College Hospital. The newly structured Education Program in Aesthetic Plastic Surgery includes the resident cosmetic clinic at Women’s College Hospital as well as the opportunity to spend time in many of the busy aesthetic plastic surgery practices in the GTA. Drs. Tutino, Zhang and Jindal were our first residents and we had a fun time during their first experience running a plastic surgery practice. Despite encountering the usual challenges that we face every day in our practices, they managed to work with some fantastic plastic surgeons, do some great aesthetic surgery cases and experience the satisfaction of helping their patients to achieve their goal to look and feel better!

Over the past year, we have received a lot of positive feedback and support from our Toronto plastic surgery family for this integral part of our training program. So far, we have been privileged to have Drs. Lista, Brown, Born, Sproule, Wanzel, Carman and Fialkov staff cases in the resident cosmetic clinic. I look forward to the involvement of more of our faculty in the resident cosmetic clinic to enhance the educational experience of our residents.

Finally, on behalf of the Division, I would like to express our sincere gratitude to Drs. Arnie Freiberg and Tom Bell for their contributions to the resident cosmetic clinic over the years. Both Arnie and Tom have helped to make our plastic surgery residency training program’s commitment to excellence in aesthetic surgery training recognized throughout Canada.

Ross Tilley Burn Centre

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Dr. Marc Jeschke

We currently have Dr. Merchant as our fellow and he is slated to finish with us in June 2013. Dr. Merchant was accepted at Yale for a trauma critical care fellowship after his completion of the burn fellowship. We have had our PGY2 residents, Joseph Catapano, Katie Armstrong, Kathryn Isaac and Ryan Austin rotate through the Burn Centre, as well as residents from various Ontario residency programs.

RTBC is organizing the first Provincial Burn Symposium. The symposium will honor Dr. Wally Peters with the First Annual Walter J. Peters Lecture and is fortunate to have Dr. Richard Gamelli from Loyola University of Chicago as its first lecturer. The burn symposium will be held June 4th at the Sunnybrook Estates. There is no conference fee. Further information can be found: http://sunnybrook.ca/burnsymposium

Publications, Last 6 Months

  1. Clouatre E, Pinto R, Banfield J, Jeschke MG. Incidence of hot tap water scalds after the introduction of regulations in ontario. Journal Burn Care Research. 2013 Mar;34 (2):243-8. doi: 10.1097/BCR.0b013e3182789057.
  2. Finnerty CC, Jeschke MG, Qian WJ, Kaushal A, Xiao W, Liu T, Gritsenko MA, Moore RJ, Camp DG 2nd, Moldawer LL, Elson C, Schoenfeld D, Gamelli R, Gibran N, Klein M, Arnoldo B, Remick D, Smith RD, Davis R, Tompkins RG, Herndon DN; for the Investigators of the Inflammation and the Host Response Glue Grant. Determination of Burn Patient Outcome by Large-Scale Quantitative Discovery Proteomics. Crit Care Med. 2013 Mar 15. [Epub ahead of print].
  3. Brooks NC, Marshall AH, Qa’aty N, Hiyama Y, Boehning D, Jeschke MG. XBP-1s is Linked to Suppressed Gluconeogenesis in the Ebb Phase of Burn Injury. Mol Med. 2013 Mar 15. doi: 10.2119/molmed.2012.00348. [Epub ahead of print].
  4. Kraft R, Herndon DN, Finnerty CC, Shahrokhi S, Jeschke MG. Occurrence of Multiorgan Dysfunction in Pediatric Burn Patients: Incidence and Clinical Outcome. Annals of Surgery. 2013 Mar 18. [Epub ahead of print].
  5. Seok J, Warren HS, Cuenca AG, Mindrinos MN, Baker HV, Xu W, Richards DR, McDonald-Smith GP, Gao H, Hennessy L, Finnerty CC, López CM, Honari S, Moore EE, Minei JP, Cuschieri J, Bankey PE, Johnson JL, Sperry J, Nathens AB, Billiar TR, West MA, Jeschke MG, Klein MB, Gamelli RL, Gibran NS, Brownstein BH, Miller-Graziano C, Calvano SE, Mason PH, Cobb JP, Rahme LG, Lowry SF, Maier RV, Moldawer LL, Herndon DN, Davis RW. Genomic responses in mouse models poorly mimic human inflammatory diseases. Proc Natl Acad Sci U S A. 2013 Feb 11. [Epub ahead of print].
  6. Marshall AH, Brooks NC, Hiyama Y, Qa’aty N, Al-Mousawi A, Finnerty CC, Jeschke MG. Hepatic Apoptosis Postburn Is Mediated by C-Jun N-Terminal Kinase 2. Shock. 2013 Feb;39(2):183-188.
  7. Hiyama Y, Marshall AH, Kraft R, Qa’aty N, Arno A, Herndon DN, Jeschke MG. The Effects of Metformin on Burn Induced Hepatic Endoplasmic Reticulum Stress in Male Rats. Mol Med. 2013 Jan 16. doi: 10.2119/molmed.2012.00330. [Epub ahead of print].
  8. Clouatre E, Gomez M, Banfield JM, Jeschke MG. Work-related burn injuries in Ontario, Canada: A follow-up 10-year retrospective study. Burns. 2013 Jan 22. doi:pii: S0305-4179(13)00004-1. 10.1016/j.burns.2012.12.020. [Epub ahead of print].
  9. Melinyshyn A, Callum J, Jeschke M, Cartotto R. Albumin Supplementation for Hypoalbuminemia Following Burns: Unnecessary and Costly! Journal Burn Care Research. 2013 Jan;34(1):8-17. doi: 10.1097/BCR.0b013e31825f3186.
  10. Kraft R, Herndon DN, Finnerty CC, Hiyama Y, Jeschke MG. Association of Postburn Fatty Acids and Triglycerides with Clinical Outcome in Severely Burned Children. J Clin Endocrinol Metab. 2013 Jan;98(1):314-21. doi: 10.1210/jc.2012-2599. Epub 2012 Nov 12.
  11. Hall KL, Shahrokhi S, Jeschke MG. Enteral Nutrition Support in Burn Care: A Review of Current Recommendations as Instituted in the Ross Tilley Burn Centre. Nutrients. 2012; 4(11):1554-1565.
  12. Herndon DN, Rodriguez NA, Diaz EC, Hegde S, Jennings K, Mlcak RP, Suri JS, Lee JO, Williams FN, Meyer W, Suman OE, Barrow RE, Jeschke MG, Finnerty CC. Long-Term Propranolol Use in Severely Burned Pediatric Patients: A Randomized Controlled Study. Annals of Surgery. 2012 Sep;256(3):402-411.
  13. A Review of the Use of Human Albumin in Burn Patients. Robert Cartotto, MD, FRCS(C), Jeannie Callum, MD, FRCP(C) J Burn Care Res 2012;33:702-717.

Congratulations to Dr. Rob Cartotto on his appointment as Chair of the Research Committee at the American Burn Association!