Plastic, Reconstructive and Hand Surgery

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  • 1. The Division ofPlastic, Reconstructive and Hand Surgery W. John Kitzmiller, MD Associate Professor of Surgery Chief, Division of Plastic, Reconstructive and Hand Surgery John.Kitzmiller@uc.edu 513.558.0984 The Division of Plastic, Reconstructive and Hand Medical Center, Shriner’s Burns Hospital Cincinnati, and TheSurgery continues to grow its clinical practice to include Drake Center’s rehabilitation programs. Partnerships withexpert care across the entire spectrum of reconstructive industry are also vital to advancing plastic and cosmeticand cosmetic surgery. Collaborative efforts with other surgery.divisions are unique and contribute to improved patientoutcomes and increased educational opportunities. Patient Care Under the leadership of Dr. John Kitzmiller, only the Faculty of the Division offer plastic, reconstructive,second Chief since its founding 33 years ago, the Division hand, and cosmetic services at Cincinnati Children’sof Plastic, Reconstructive and Hand Surgery has expanded Hospital, The University Hospital, the Veteran’s Affairsits faculty and practice area.The new faculty members offer Medical Center, Shriners Burns Hospital Cincinnati, Theinnovative approaches to complex problems, and the Drake Center, University Pointe, and the surroundingDivision has expanded its cosmetic practice to the community. Central to these patient care activities isUniversity Pointe. Cosmetic Surgery at University Pointe coordination with other surgical specialties to provideoffers state-of-the-art skin care and cosmetic surgery in state-of-the-art care including breast reconstructionthe recently completed operating rooms at the JCAHO- after mastectomy, reconstructive and cosmetic surgerycertified University Pointe Surgical Hospital. following trauma, brachial plexus (nerve injury to the hand), weight loss, and complex wound management. The Division of Plastic Surgery brings significantresources to patient care and education. Its research The Division continues its collaborative effort with Thecrosses many arms of the academic health center and Drake Center, Cincinnati’s primary rehab hospital. Membersbeyond. The Division of Plastic Surgery is a key player with- of the Division see patients in the facility’s multidisciplinaryin the Skin Sciences Institute, Cincinnati Children’s Hospital wound evaluation and treatment center, which makes best The Division of Plastic, Reconstructive and Hand Surgery | Page 76
  • 2. use of these health care resources to obtain optimal out-comes for patients. Clinical pathways have been defined,and outcomes and costs are tracked. The rapid growth ofthis clinic is a clear demonstration of the community needfor this service. The Drake Center is also supporting clinicalresearch focused on finding better ways of treating com-plex wound healing problems. The Drake Wound Team hasbeen increasingly recognized for its achievements andinnovations. Collaboration with Steven Boyce, PhD, is expanding theapplications of tissue-engineered skin developed inDr. Boyce’s laboratory at the Shriners Burns HospitalCincinnati. In addition, Dr. Dorothy Supp and her team ofresearchers at the Shriners Burns Hospital Cincinnaticreated genetically modified skin cells that, when added tocultured skin substitutes, may help fight off potentiallylethal infections in patients with severe burns. Dr. Supps Dr. John Kitzmiller and Dr. Christopher Gordon arefindings appeared in the January/February 2007 issue of certified by the American Board of Plastic Surgery, and offerthe Journal of Burn Care and Research and were featured in their patients surgical consultation for body contouring,the national media. facial enhancements, and reconstructive surgery. Dr. Jesse Taylor, joining the practice in September 2007, will see Dr. Kevin Yakuboff has expanded services at Cincinnati patients seeking surgical consultation for body contouring,Children’s Hospital for hand and brachial plexus surgery to facial enhancements, and reconstructive surgery.repair damaged nerves controlling muscles in the shoul-der, arm, or hand. The program has grown rapidly since its Cathy Fricke, skin care specialist and licensed cosme-inception. tologist, complements the surgical team by providing advanced skin care treatments that will assist clients in Dr. David Billmire continues his expert specialty care of achieving and maintaining their desired look. A member ofcraniofacial and pediatric plastic surgery patients at the the Society of Plastic Surgical Skin Care Specialists, CathyCincinnati Children’s Hospital. sees skin care patients as well as postoperative surgery patients. Non-invasive procedures such as Fraxel® LaserCosmetic Surgery at University Pointe and Intense Pulsed Light (IPL) treatments are performed in In October 2004, the Division established a dedicated the office and are alternatives for patients looking for acosmetic surgery office at University Pointe in the subur- change with less downtime than after surgery.ban community of West Chester. This private practicesetting provides an unparalleled experience for those seek- Educationing state-of-the-art cosmetic surgery and skin care. The The Plastic, Reconstructive and Hand SurgeryDivision has also been at the lead in the opening and residency is the cornerstone of the Division, and theactivity of the Joint Commission on Accreditation of Director and faculty are dedicated to providing an environ-Healthcare Organizations (JCAHO) certified University ment for training of plastic surgeons within the entirePointe Ambulatory Surgical Hospital. Patients are now pro- spectrum of plastic surgery. Both the independent (5 + 2)vided a full range of advanced skin care, all types of facial pathway in plastic surgery training and the integrated (3 +cosmetic surgery, body contouring and breast procedures. 3) pathways for residency training are maintained and fully accredited. The rotations, progression, knowledge, skill and responsibility will vary according to the pathway and the individual, but the ultimate level of proficiency and dedica- tion to the Division’s core values is the same for all residents. The Division works with the Department of Surgery and The Health Alliance to continually provide an optimal resident work environment. The residency program was given full 5-year accredita- tion by the ACGME in January 2007. A mentored research project is available to all resi- dents, beginning during their internship and extending through their chief residency. The goals are (1) to ensure that residents gain exposure to both basic science and The Division of Plastic, Reconstructive and Hand Surgery | Page 77
  • 3. translational research, (2) to facilitate the development oftheir individual interests, and (3) to oversee completion ofa defined study (basic science, translational, or outcome) Henry and Margaret Nealeduring their six-year training period. Each resident meets Library Dedicationtwice yearly with the Residency Research Project This past winter, the Department of Surgery sponsored aCommittee. The goal is completion of a particular project major renovation of the Plastic Surgery office and conferenceduring the residency period, culminating in presentation at room. On Saturday, June 9, 2007, the new library wasa national meeting and publication in a reputable journal. dedicated in the name and honor of Henry and Margaret Medical students and trainees in other surgical disci- Neale. The special event was held in conjunction with the 2007 Chief Resident Graduation Weekend on June 8-9, 2007.plines regularly rotate to the Division of Plastic Surgery.Thisrotation exposes them to the fundamentals of surgical On Saturday, June 9, 2007, a special Plastic Surgery Grandtechnique and wound management. Orthopedic fellows Rounds was held in the Surgical Amphitheater. The agendarotate with plastic surgery residents for training in upper included presentations from current residents, faculty, andextremity surgery. Third-year medical students rotate for alumni. Dr. Jesse Taylor was special Visiting Professor, pre-three weeks in plastic surgery, which allows them the senting on behalf of Dr. Fernando Ortiz-Monesterio.opportunity for additional anatomic dissections. Following this event, everyone moved to the division offices for the dedication. Later that evening, the Chief Resident The Division continues to actively participate in Recognition Dinner was held at the home of Dr. John andContinuing Medical Education (CME) related to plastic Mrs. Sarah Kitzmiller, where graduating plastic surgery resi-surgery in our community. Topics include craniofacial dent Dr. Ryan Flannagan was honored.anomalies, facial reanimation, skin sciences, microsurgeryand replantation. Henry and Margaret Neale met in the summer of 1960 in Montreat, North Carolina, and were married in 1964. Dr. John Kitzmiller and other faculty in the Division Following his graduation from the Medical College ofcontinue their collaborations with the cosmetic science Virginia, Henry and Margaret moved to Springfield, Ohio,program at the UC College of Pharmacy, led by Randy where Dr. Neale began a rotating internship at MercyWickett, PhD, professor and director. The UC College of Medical Center.Pharmacy is the first in the United States to have graduateprograms that emphasize cosmetic science and offer an Dr. Neale completed his general surgery residency at theonline degree program in this specialty. In addition, several University of Cincinnati and subspecialty training in plastic surgery at Duke University. He was encouraged by Dr.collaborative projects studying cellulite have been com- William Altemeier to return to Cincinnati, where he found-pleted or are in progress, coordinated by Marty Visscher, ed the Division of Plastic Surgery in 1974 and was itsPhD, of the Cincinnati Children’s Hospital Research Director for 29 years until his retirement in 2003. Dr. NealeFoundation’s Skin Sciences Institute. An article on the effect trained 36 residents who now practice in all corners of theof weight loss on cellulite was published in Plastic and United States. He served as a teacher and mentor for medi-Reconstructive Surgery in August 2006. cal students, residents, and faculty by personally setting and living by the highest standards for clinical excellence, integri- Visiting professors to the Division during the past year ty and interpersonal behavior.included Drs. Francois Firmn from Paris, who spoke on “EarReconstruction,”and Dr. Jesse Taylor, who spoke on “The Artof Moving Orbits.” Dr. Taylor is joining the plastic surgeryfaculty in September 2007. Research Members of the Division are working on research projects concentrated on improving treatment of craniofa- cial deformities, major burns, scarring and aging skin changes. Research currently incorporates basic and transla- tional research as well as clinical research projects. The addition of new faculty has positioned the Division for tar- geted growth in research. Dr. Chris Gordon continues his research on distraction osteogenesis, bone biology and outcome studies of minimally invasive techniques in craniofacial surgery. He holds patents on several distractor devices which were designed to correct pediatric facial deformities using mini- mally invasive techniques. A research project is underway by Dr. Gordon using microarray technology to study patterns of gene expression in neonatal mandibular The Division of Plastic, Reconstructive and Hand Surgery | Page 78
  • 4. distraction callus, with the aim of correcting facial bone deformities in children. An established collaboration with the Skin Sciences Institute has further enhanced the Division’s position as a leader in understanding skin changes. The Skin Sciences Institute is a multidisciplinary group of researchers from Cincinnati Children’s Hospital Research Foundation, the Departments of Surgery and Dermatology, the Shriners Burns Hospital Cincinnati and the Colleges of Pharmacy, Engineering and Nursing at the University of Cincinnati. Research efforts are focused on infant skin development, wound healing and skin restoration. With funding from the Aesthetic Society Education and Research Foundation, the Division completed and published a study designed to make laser skin treatments safer and more predictable. Another study near completion Community Connections is to more precisely define the outcomes of two common- The Division occasionally offers a Fraxel® Workshop for ly used skin peeling strategies. The clinical skin care Reliant Technologies at the University Pointe location. The program continues to provide an important service for purpose of the workshop is to give an overview of a suc- patients. The Division began a major study of how fat (or cessful Fraxel® laser practice as seen through the physi- cellulite) distributes itself across the body, funded by a cian’s eyes as well as a demonstration of an actual treat- grant from Procter & Gamble, in partnership with the UC ment including useful information on the procedure and Center for Surgical Weight Loss at University Pointe. pre- and post-operative care. Dr. Kitzmiller and plastic surgery resident Dr. Ryan Reconstructive surgery for burned children is provided Flannagan, in collaboration with Ethicon Endo-Surgery, free of charge to families at the Shriners Burns Hospital developed a protocol for IRB consideration to advance the Cincinnati. Dr. Kevin Yakuboff represents the Division of use of the Harmonic scalpel in plastic surgery, particularly Plastic Surgery in this effort as part of a multidisciplinary abdominoplasty. Dr. Kitzmiller visited a plastic surgery team team dedicated to restoring health and function to chil- in Paris with Ethicon Endo-Surgery to study new applica- dren suffering burn injuries. Dr. Yakuboff is also a co- tions of the harmonic scalpel to minimize recovery times founder and team member of the Interplast Cleft Lip and following cosmetic surgery. Palate Team which from 1995 to 2001 sent medical teams to the Philippine Islands to treat children afflicted with cleft Dr. Chris Gordon had two presentations at the Plastic lip and palate. The organization is now called Changing Surgery Research Council Annual Meeting, June 20-23, Faces and continues its medical missions to the Philippine 2007, in Stanford, California. Islands. Dr. Kevin Yakuboff is co-investigator of a multicenter Dr. Christopher Gordon has strengthened his interna- research study on “Prospective Study of the Treatment of tional collaboration with Dr. Fernando Ortiz-Monesterio Brachial Plexus Birth Palsy.” The local research arm is locat- and the National Children’s Medical Center in Mexico City. ed at Cincinnati Children’s Hospital Medical Center, one of Together they are studying endoscopic treatment of nine centers in the study headed by Boston Children’s frontofacial deformities in children and the cellular mecha- Hospital. nisms regulating new bone formation in distraction osteo- genesis. He has completed several medical missionary trips that have improved the lives of many needy children in Guatemala and Venezuela. He has also lectured in Paris2500 5000 5 800 1500 7002000 4000 4 1200 6001500 3000 3 500 900 4001000 2000 2 300 600 200500 1000 1 300 100 0 0 0 The Division of Plastic, Reconstructive and Hand Surgery | Page 79
  • 5. regarding distraction osteogenesis and outcome studies inminimally invasive techniques in craniofacial surgery. Dr. Kevin Yakuboff was inducted into the AmericanAssociation of Plastic Surgeons. He hosted the BrachialPlexus Conference held in June 2007 at CincinnatiChildren’s Hospital Medical Center, with renowned brachialplexus expert Dr. Alain Gilbert from Paris serving as visitingprofessor. In addition to hosting an annual golf outing, theDivision sponsors tennis events and an open house at theCosmetic Surgery at University Pointe center.Faculty(To view the full CV, visit our website at http://surgery.uc.edu)W. John Kitzmiller, MD, FACS reconstruction, and brachial plexus reconstruction. He isAssociate Professor of Surgery certified by the American Board of Surgery and theChief, Division of Plastic, Reconstructive and Hand Surgery American Board of Plastic Surgery with AddedDirector, Plastic Surgery Residency Program Qualification in Surgery of the Hand.Dr. Kitzmiller specializes in reconstructive microsurgery, Christopher B. Gordon, MDcorrection of aging skin changes, and wound healing. He is Assistant Professor of Clinical Surgerycertified by the American Board of Surgery and theAmerican Board of Plastic Surgery with Certificate of Dr. Gordon specializes in minimally invasive craniofacialAdded Qualification in Surgery of the Hand. surgery and general cosmetic surgery. He is certified by the American Board of Plastic Surgery.David A. Billmire, MD, FACSAssociate Professor of Clinical Surgery Jesse A. Taylor, MD [effective September 2007]Director, Craniofacial and Pediatric Plastic Surgery, Assistant Professor of Clinical Surgery Cincinnati Children’s Hospital Medical Center Dr. Taylor specializes in minimally invasive reconstructiveDr. Billmire specializes in craniofacial surgery. He is certified and cosmetic surgery, with special expertise in state-of-by the American Board of Surgery and the American Board the-art treatment for facial cosmetic surgery and bodyof Plastic Surgery. contouring, including laser treatment for non-invasive resurfacing of the skin for wrinkles and sun damage.Kevin P. Yakuboff, MD, FACS Dr. Taylor completed his general and plastic surgeryAssociate Professor of Surgery residencies at Johns Hopkins Hospital and University ofChief of Plastic and Reconstructive Surgery, Maryland, and a fellowship in craniofacial and aesthetic Shriners Burns Hospital Cincinnati surgery at Hospital M. Gea Gonzalez, Mexico City, under the direction of the world-renowned Dr. Fernando Ortiz-Dr. Yakuboff specializes in microsurgical reconstruction of Monesterio who is considered the “Father of Craniofacialcomplex wounds, surgery of the hand, acute burn care and Surgery.” Dr.Taylor conducts research on microsurgery and skin healing. Further information on the Division of Plastic Surgery, including presentations and publications, can be viewed on our website http://surgery.uc.edu. The Division of Plastic, Reconstructive and Hand Surgery | Page 80
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