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Plastic and Reconstructive Surgery

Research activities

OVERVIEW

The Division of Plastic and Reconstructive Surgery is committed to excellence in plastic surgery and craniofacial research. Our research mission is to conduct clinical, translational and basic science research that aims to improve the quality of life of children and families with congenital and acquired conditions of the skin, head, neck, face and upper extremities.

The Division takes pride in our basic science and clinical researchers who are recognized locally and internationally for their innovations. Our team includes senior and associate scientists, principal investigators, project investigators, clinical research managers and coordinators, plastic surgery and craniofacial fellows, medical students, summer students and a division-wide research manager

CLINICAL AND TRANSLATIONAL RESEARCH

    • Burns and Scar Management
    • Cleft Lip and Palate
    • Cornea Neurotization
    • Craniofacial
    • Facial Paralysis
    • Brachial Plexus Birth Injury
    • Upper Limb and Hand

Burns and Scar Management 

Under the leadership of Dr. Joel Fish, the research that is conducted in the Burn Unit spans the entire burn injury experience. Our current studies range from investigating acute burn wounds to evaluating patient outcomes. At present, several of our most innovative research studies are focused on investigating the use of laser therapy for scar modulation. Our doctoral student, Jennifer Zuccaro is spearheading a clinical trial designed to determine the effectiveness of laser therapy for improving hypertrophic scars. Ultimately, the results of this trial may lead to a paradigm shift in the way scars are treated and encourage other burn centres in North America to invest in laser therapy for their patients.

Understanding the impact of burns and scars on the health related quality of life of our paediatric patients is also paramount to optimizing management of scars. In partnership with Dr. Andrea Pusic and Dr. Anne Klassen, our burn research team have developed the SCAR-Q, a patient-reported outcome measure for children with scars.

Cleft Lip and Palate 

With the leadership of Dr. David Fisher, the cleft lip and palate program is world renowned for research in advancing the surgical approach to cleft lip and palate repair. In collaboration with the Americleft Outcomes group, our research in this program aims to evaluate the surgical, speech and psychosocial outcomes in children with cleft lip and/or palate. Our inter-disciplinary team has recently developed a new speech outcomes tool for children with cleft palate called the SickKids Cleft Speech Tool. Currently, this tool is undergoing a validation study that involves speech language pathologists throughout North America. In collaboration with the Hospital's Centre for Image Guided Innovation and Therapeutic Intervention, Dr. Dale Podolsky alongside Drs. David Fisher, Christopher Forrest and Karen Wong have developed a cleft lip and cleft palate simulator. Current research is underway to evaluate the benefits of using these simulators for surgical skills training.

Enhancing the quality of life of children and families with Cleft Lip and Palate is a priority research area of this program. The development of patient-reported outcome measures (PRO) to evaluate the child and family’s experience with this condition is critical to this understanding. The team of Dr. Karen Wong and Dr. Christopher Forrest are paving the way in their development and validation of the CLEFT-Q and FACE-Q Kids. The CLEFT-Q is a standardized PRO measure for children with cleft lip and/or palate. FACE-Q Kids is a standardardized PRO measure for children with facial differences.

Corneal Neurotization

Corneal Neurotization Corneal neurotization is a minimally invasive novel technique performed by Dr. Ronald Zuker and Dr. Greg Borschel that restores corneal innervation in patients with neurotrophic keratopathy (NK). Together with Dr. Ali Asim, Ophthalmologist, Drs. Zuker and Borschel are leading the world in both basic science and clinical research to further our understanding of this disease, the mechanisms involved in this procedure and methods to advance medical care. This team has established an international registry to evaluate and study the outcomes of corneal neurotization.

Craniofacial In collaboration with the Hospital's Centre for Image Guided Innovation and Therapeutic Intervention, and an international team of collaborators, Dr. Christopher Forrest and Dr. John Phillips are using innovative imaging technology to generate a 3D morphometric analysis of the skull to conduct comparative analysis of craniosynostosis.

Facial Palsy

Dr. Ronald Zuker and Dr. Greg Borschel are co-directors of our research program in the facial palsy program. This program combines both basic science and clinical research to evaluate the outcomes of facial reanimation in the paediatric population using the gracilis muscle transplantation.

Brachial Plexus Birth Injury

The research of the brachial plexus program at SickKids has received international recognition under the leadership of Dr. Howard Clarke and Dr. Kristen Davidge. This team is known internationally for their leadership in evaluating systematic outcomes in this population.

The Active Movement Scale (AMS) is a valid and reliable motor assessment of the upper extremity in infants with brachial plexus injury.  See the clinicians guide to the use of the Active Movement Scale.

The Brachial Plexus Outcome Measure (BPOM)  is a valid functional outcome assessment in school-aged children with brachial plexus injuries. See the BPOM manual. Both the AMS and BPOM are outcome measures used nationally and internationally to evaluate outcomes in children with brachial plexus birth injury. For more information, please contact Emily Ho.

Under the direction of Dr. Kristen Davidge, we are investigating the nature of pain in children with brachial plexus birth injuries. Emily Ho is conducting qualitative research on health literacy and shared decision making youth with brachial plexus birth injury through the development and validation of a patient decision aid. See AboutKidsHealth for more.

Hand and Upper Limb

Ongoing clinical research to evaluate surgical and non-surgical interventions for children with congenital hand differences and traumatic hand injuries is essential to optimize outcome. The research collaborations of Dr. Kristen Davidge, Dr. Howard Clarke, Dr. Greg Borschel and Emily Ho focuses on establishing valid and reliable methods of evaluating pediatric upper extremity function in this population to conduct such evaluations. Currently, we are conducting a large retrospective cohort study on outcome of paediatric hand fractures and peripheral nerve injuries.

With the leadership of Dr. Davidge, the team is developing new initiatives to provide teen to teen mentorship for children with congenital limb differences. Priority is placed on employing qualitative methods to understand the family’s perspective of their child’s upper extremity condition.

RECENT PUBLICATIONS

See recent publications from the Division of Plastic and Reconstructive Surgery.