Labs and People
Our research facilities and personnel are housed within our multiple teaching hospitals. Our Division’s active research interests include tissue engineering, burn and wound healing research, nerve regeneration, information technology in medicine, surgical simulation, bone healing, ischemia-reperfusion injury, anatomic studies, and clinical outcome studies involving all subdisciplines of plastic surgery.
Bringing a Revolutionary Invention to the World
Repairing Wounds through 3D Print Technology
Under the direction of Dr. Marc Jeschke, Professor in the Division of Plastic and Reconstructive Surgery, innovative thinking by a team at the University of Toronto’s Institute of Biomaterials and Biomedical Engineering led to the invention of a prototype 3D printer that creates artificial skin that almost exactly resembles human skin.
The potential opportunities to help patients suffering from any type of wound through use of this exciting technology are boundless.
As the Director of the Ross Tilley Burn Centre that treats more than 80 per cent of all burn cases in Ontario, Dr. Jeschke sees where this technology can have an immediate impact.
“We have a social responsibility to make this technology available to patients, particularly in parts of the world where it means improving chances of survival.”
– Dr. Marc Jeschke
Improving Quality of Life
Regenerative Medicine and Nerve Injury
Injury to a nerve can result in a devastating impairment to a patient with loss of movement and sensation, which limit their ability to independently perform simple everyday tasks. Unfortunately, current surgical techniques in nerve repair do not result in full return of function. However, at U of T there’s an exciting opportunity to improve patient outcomes. Dr. Greg Borschel, Assistant Professor in the Division of Plastic and Reconstructive Surgery and the Institute of Biomaterials and Biomedical Engineering, has been leading the investigation of innovative methods to improve our understanding of peripheral nerve injury. By using specific compounds that deliver nerve growth factors for motor nerve injury as well as tissue engineering techniques for the repair of peripheral nerve gaps, Dr. Borschel’s groundbreaking work has the potential to improve care and outcomes in infants, children and adults who suffer from trauma or cancers that impact the function of peripheral nerves.
Impacting Cleft Care Around the World
Global Outreach in Low and Middle-income Countries
Today, the incidence of infants born with cleft lip and/or palate is one in 700 live births worldwide. The care of these infants requires timely intervention that is contingent upon understanding the impact of this condition on the quality of life of patients and their families. Dr. Karen Wong, Assistant Professor at the Division of Plastic and Reconstructive Surgery, is designing a tool that will evaluate the child and family’s experiences with the condition, during and post-treatment, to better determine quality of life from the patient’s perspective, which will inform future care. The development of Cleft-Q, the first-ever patient-reported outcomes instrument for children with cleft lip and/or palate, is a multi-disciplinary, multi-site initiative with international partners, which will help to provide improved care to those in greatest need around the globe.
Breaking Down Silos and Improving Patient Outcomes
A Central Information Initiative for Breast Cancer Care
With an average of 65 women being diagnosed with breast cancer each day in Canada, the demand for quality and timely treatment and support is unsurprisingly high. Currently, the wait time for breast reconstructive surgery sits at six to 12 months; a timeframe that could be dramatically reduced through a coordinated effort to centralize patient information and care resources at various hospitals across the Greater Toronto Area. Throughout the downtown Toronto core, our Division’s 10 breast reconstructive surgeons each treat a high volume of patients, collecting information that provides invaluable insight into patient care and informs their research.
“The model we develop here would revolutionize patient care and could provide a framework for other regions.”
– Dr. Toni Zhong
Part of the vision for the Division is to centralize this wealth of information; thereby, encouraging collaboration, transferring knowledge about available care throughout the city and improving the quality of life of breast cancer patients. “A central information network would be the first of its kind for breast cancer care in North America,” says Dr. Toni Zhong, Assistant Professor in the Division of Plastic and Reconstructive Surgery and Director of the Breast Reconstruction Fellowship Program. From immediately knowing where to refer a patient for more immediate quality care, to greater understanding of post-surgery success, this initiative would provide a wealth of readily accessible information to surgeons.
UHN Breast Reconstruction Team
Our research program has the unique opportunity to enhance the patient experience with post-mastectomy breast reconstruction (PMBR) on the entire spectrum from advancing surgical methods at a cellular level to extending timely access to all patients who seek the procedure.
The basic science research component of our program focuses on improving the reconstructive techniques used in our clinical practice. The recent discovery of a stem cell population in adult fat may have many benefits for tissue regeneration as they could offer a minimally invasive solution to complex reconstructive problems. The oncological safety of these techniques has not yet been established as there are many studies that demonstrate enhanced tumor growth in the presence of stem cells. Our research aims to improve our understanding of the interaction between fat derived stem cells and breast cancer cells so that we can determine whether novel stem cell based reconstructive techniques are a safe option for patients following cancer. We also study methods of extending the ischemic tolerance of tissue in an effort to enhance the safety and efficacy of free vascularized tissue transfer, limb replantation and composite tissue allotransplantation.
In terms of the clinical research component of our program, we have designed a three-pronged approach that includes (a) Identification of novel models of decision support, including peer support, to promote high-quality shared decision-making for PMBR, (b) evaluation of patient-reported outcomes (PROs) following different PMBR techniques through clinical trials and prospective, longitudinal studies and (c) population-based health services research to identify barriers to PMBR access.
Additionally, our program plans to focus on knowledge translation and dissemination of our research findings not only in the scientific community, but by working with our community partners to improve health care access to PMBR breast cancer survivors and previvors.