Division of the Month: Plastic Surgery

The Division of Plastic Surgery

The Division of Plastic Surgery focuses on advancing knowledge in the field to improve patient outcomes. The Division features research expertise in basic science, clinical research, global surgery, and surgical education. In addition to a well-rounded faculty with subspecialty expertise encompassing the entire field of plastic surgery, our residency training program emphasizes the importance of research and incorporates a clinical investigator CaRMS position every two years to promote high quality research.

Key areas of research include:

Burn/Skin/Wound healing

Drs. Tredget and Kwan have extensively investigated skin biology and cultured skin substitute engineering within the wound healing basic science laboratory.  Dr. Armour has interests in burn and frostbite outcomes, and clinical advancements in adult and pediatric burn care and scar treatment. Josh Wong's research interests include innovation and integration of artificial intelligence in clinical medicine and surgery. In the last 3 years this has culminated in collaborative projects across the country such as early diagnosis of skin cancer using a smartphone application, assessing burn depth using AI, validation of AI burn depth analysis with LDI, evaluation of hypertrophic and keloid scar using AI video, examination of skin substitutes and their healing using AI, and assessing skin ulcer healing using AI. The future projects involve assessment of skin disease healing using AI and development of a first-responder application with integrated AI to help with initial assessment and management of burn injury.

Kwan PO, Tredget EE. Biological Principles of Scar and Contracture. Hand Clin. 2017 May;33(2):277-292. doi: 10.1016/j.hcl.2016.12.004. Epub 2017 Mar 1. PMID: 28363295.

Agrawal A, Ding J, Agrawal B, Kwan PO, Tredget EE. Stimulation of toll-like receptor pathways by burn eschar tissue as a possible mechanism for hypertrophic scarring. Wound Repair Regen. 2021 Sep;29(5):810-819. doi: 10.1111/wrr.12940. Epub 2021 May 27. PMID: 34043867.

Varkey M, Ding J, Tredget EE. Advances in Skin Substitutes-Potential of Tissue Engineered Skin for Facilitating Anti-Fibrotic Healing. J Funct Biomater. 2015 Jul 9;6(3):547-63. doi: 10.3390/jfb6030547. PMID: 26184327; PMCID: PMC4598670.

Ethier O, Chan HO, Abdolahnejad M, Morzycki A, Tchango AF, Joshi R, Wong JN, Hong C. Using Computer Vision and Artificial Intelligence to Track the Healing of Severe Burns. J Burn Care Res. 2023 Dec 21:irad197. doi: 10.1093/jbcr/irad197. Epub ahead of print. PMID: 38126807.

Peripheral nerve

Drs. Olson, Morhart, and Curran, in collaboration with the laboratories of Dr. Ming Chan and Dr. Christine Webber, have investigated strategies to optimize nerve regeneration and functional recovery following nerve injury.  Work on the beneficial effects of electrical stimulation on nerve regeneration has translated to clinical application, culminating in a randomized multi-center trial evaluating a commercial therapeutic nerve stimulator.  Drs. Power and Ladak have collaborated with Dr. Jaqueline Hebert (Physiatry) and Dr. Rob Stiegelmar (Orthopedics) to investigate the benefits of functional nerve reconstruction following amputation.  Current work includes an international multi-center clinical trial comparing targeted muscle reinnervation and regenerative peripheral nerve interfaces for the primary prevention of post-amputation pain.  Additionally, a DOD grant was recently awarded to the group to study upper limb oseo-integration with concurrent targeted muscle reinnervation to optimize functional outcomes for upper limb myoelectric prostheses.

Senger JB, Rabey KN, Morhart MJ, Chan KM, Webber CA. Conditioning Electrical Stimulation Accelerates Regeneration in Nerve Transfers. Ann Neurol. 2020 Aug;88(2):363-374. doi: 10.1002/ana.25796. Epub 2020 Jun 26. PMID: 32447758.

Wong JN, Olson JL, Morhart MJ, Chan KM. Electrical stimulation enhances sensory recovery: a randomized controlled trial. Ann Neurol. 2015 Jun;77(6):996-1006. doi: 10.1002/ana.24397. Epub 2015 May 4. PMID: 25727139.

Chan KM, Gordon T, Zochodne DW, Power HA. Improving peripheral nerve regeneration: from molecular mechanisms to potential therapeutic targets. Exp Neurol. 2014 Nov;261:826-35. doi: 10.1016/j.expneurol.2014.09.006. Epub 2014 Sep 16. PMID: 25220611.

Gordon T, Sulaiman OA, Ladak A. Chapter 24: Electrical stimulation for improving nerve regeneration: where do we stand? Int Rev Neurobiol. 2009;87:433-44. doi: 10.1016/S0074-7742(09)87024-4. PMID: 19682653.

Pettersen E, Sassu P, Reinholdt C, Dahm P, Rolfson O, Björkman A, Innocenti M, Pedrini FA, Breyer JM, Roche A, Hart A, Harrington L, Ladak A, Power H, Hebert J, Ortiz-Catalan M. Surgical treatments for postamputation pain: study protocol for an international, double-blind, randomised controlled trial. Trials. 2023 May 2;24(1):304. doi: 10.1186/s13063-023-07286-0. Erratum in: Trials. 2023 Oct 9;24(1):654. PMID: 37131180; PMCID: PMC10155377.

Craniofacial reconstruction

Drs. Louie, Budden and DeSerres have investigated techniques in optimizing facial reconstruction following traumatic injuries as well as optimizing the treatment of congenital craniosynostosis.

Nickel KJ, DeSerres JJ, Louie G. Utility of the LeFort I Osteotomy in the Acute Management of Midface Trauma. J Craniofac Surg. 2023 Dec 11. doi: 10.1097/SCS.0000000000009917. Epub ahead of print. PMID: 38078924.

Platt A, Budden C, Badilla J, Pollock N, Louie G, Mehta V. Beare-Stevenson Syndrome With Blepharoptosis as a Complication of Front-Orbital Advancement and Remodeling. J Craniofac Surg. 2020 Sep;31(6):1780-1781. doi: 10.1097/SCS.0000000000006638. PMID: 32604297.

Persad AR, Bhargava R, Louie G, Mehta V. Delayed Unilateral Coronal Synostosis Following Metopic Synostosis Repair. Can J Neurol Sci. 2016 Mar;43(2):322-5. doi: 10.1017/cjn.2015.315. Epub 2015 Nov 20. PMID: 26586180.

Breast reconstruction

Dr. Momtazi’s interests include quality improvement, patient experience and surgical management of lymphedema.  His prospective study on lymphovenous bypass for immediate lymphatic in breast cancer patients undergoing axillary node dissection has been accepted for publication and should appear in the Journal of Reconstructive Microsurgery in May 2024. His current work on lymphedema is in collaboration with Dr. Spencer Gibson who is the inaugural Dianne and Irvin Kipnes Chair in Lymphatic Disorders. Dr. Wolfli has an interest breast reconstruction outcomes including animation deformity following reconstruction with latissimus dorsi flaps and sensory reinnervation of free flaps for breast reconstruction.

Head LK, Momtazi M. Economics of Lymphovenous Bypass. Plast Reconstr Surg. 2019 Nov;144(5):751e-759e. doi: 10.1097/PRS.0000000000006118. PMID: 31688749.

Senger JL, Wolfli J. Late animation deformity in the denervated pedicled latissimus dorsi flap. Breast J. 2020 Apr;26(4):685-690. doi: 10.1111/tbj.13497. Epub 2019 Aug 25. PMID: 31448462.

Global Surgery

Dr. Guilfoyle is integrally involved with the office of global surgery within the department of surgery.  She has completed a post-graduate masters degree in global surgery and is involved in many global outreach initiatives.  This has led to research looking at the formation of global healthcare partnerships and ethical considerations arising from such frameworks.

Grant CL, Robinson T, Al Hinai A, Mack C, Guilfoyle R, Saleh A. Ethical considerations in global surgery: a scoping review. BMJ Glob Health. 2020 Apr 21;5(4):e002319. doi: 10.1136/bmjgh-2020-002319. PMID: 32399258; PMCID: PMC7204923.

Guilfoyle R, Morzycki AD, Saleh A. What makes global healthcare partnerships successful? A systematic review. Glob Public Health. 2022 May;17(5):662-671. doi: 10.1080/17441692.2021.1892795. Epub 2021 Mar 9. PMID: 33689576.

Surgical education

Dr. Budden as spear-headed research in surgical education within our division.  During his training, he completed a Masters of Science in surgical education.  He has shared his knowledge practically to improve our residency training program and continues to investigate opportunities for improvement in the delivery of surgical education.

Budden C, Platt A, Jack A, Moulton R, Olson J, Mehta V. Peripheral nerve surgical competency in plastic surgery and neurosurgery residents. Clin Neurol Neurosurg. 2022 May;216:107217. doi: 10.1016/j.clineuro.2022.107217. Epub 2022 Mar 22. PMID: 35339861.

Budden CR, Svechnikova K, White J. Why do surgeons teach? A qualitative analysis of motivation in excellent surgical educators. Med Teach. 2017 Feb;39(2):188-194. doi: 10.1080/0142159X.2016.1248384. Epub 2016 Nov 10. PMID: 27832726.

Robertson EM, Budden CR, Ball BJ, Ladak A. The Utility and Efficiency of a Resident Hand Clinic for the Management of Acute Hand Trauma at the University of Alberta. Plast Surg (Oakv). 2019 May;27(2):195-199. doi: 10.1177/2292550318800323. Epub 2018 Oct 3. PMID: 31106180; PMCID: PMC6505360.