Cold Steel: Canadian Journal of Surgery Podcast

Podcast transcript: https://www.canjsurg.ca/content/e142-masterclass-dennis-kim-trauma-icu-rounds-fascial-dehiscence

This week, we were joined by trauma surgeon and podcaster Dr. Dennis Kim. Dr. Kim, among many other things, hosts the very successful and highly educational Trauma ICU Rounds podcast. We in Canada are lucky enough to have him back on Canadian soil, and so on this episode talked to him about his experience moving back to Canada and collaborating to develop a trauma system in Victoria, BC. We then delved into a masterclass on fascial dehiscences, ranging from closure techniques to prevent dehiscences in the first place to strategies for dealing with them when they happen.

Links:

1. https://www.traumaicurounds.ca/

2. STITCH trial: https://pubmed.ncbi.nlm.nih.gov/26188742/

3. Wittmann Patch: https://medizzy.com/feed/46410

4. ABRA Closure Device: https://www.cjmedical.com/products/specialties/dynamic-tissue-systems/abra-abdominal-wall-closure

Bio (from https://medicalstaff.islandhealth.ca/news-events/dr-dennis-kim):

Originally from Toronto, Dr. Kim completed medical school at McMaster University followed by General Surgery residency and a Critical Care Medicine fellowship at the University of Ottawa. He subsequently underwent a 2-year fellowship in Trauma & Surgical Critical Care at UC San Diego. Dr. Kim is quadruple board certified in Canada and the US. Dennis has been an attending surgeon in the Division of Trauma/Acute Care Surgery/Surgical Critical Care at Harbor-UCLA Medical Center in South Los Angeles since 2012, where he served as the Medical Director of the Trauma SICU and Chair of the Hospital Critical Care Committee. An avid educator and recipient of several teaching awards, Dr. Kim is an Associate Professor of Clinical Surgery and the former Co-Chair of the College of Applied Anatomy at the David Geffen School of Medicine at UCLA.

Dr. Kim is actively involved in and holds numerous leadership roles in several key national trauma organizations including EAST, AAST, and the American College of Surgeons Committee on Trauma. He has published over 140 peer-reviewed publications, 25 book chapters, and several Practice Management Guidelines focused on the optimal care of critically injured and ill patients. Dr. Kim hosts the very popular Trauma ICU Rounds Podcast and is active across several social media platforms.

Dr. Kim joins us with his wife, Alexis, their four children, and dog. Traveling, cooking, and spending time in the outdoors are but a few of the activities that help bring balance and joy to the de Rosenroll-Kim family.

Dr. Kim brings with him a wealth of experience regarding trauma program development, performance improvement, and patient safety initiatives.

Podcast transcript: https://www.canjsurg.ca/content/e127-rob-leeper-competitive-motivation-trauma-simulation-and-starting-out-practice

Dr. Rob Leeper is a trauma surgeon at Western University in London, Ontario. We spoke with Dr. Leeper about his work on trauma simulation and particularly on his work on data drive competitive motivation strategies. Finally, Dr. Leeper shared with us the tips that he wished he had when started out in practice.

Links:

1. Data Driven Competitive Motivation Strategies in a Longitudinal Simulation Curriculum for Trauma Team Training. https://pubmed.ncbi.nlm.nih.gov/30833203/

2. Multidisciplinary Difficult Airway Course: An Essential Educational Component of a Hospital-Wide Difficult Airway Response Program. https://pubmed.ncbi.nlm.nih.gov/29628333/

3. The role of trauma team leaders in missed injuries: does specialty matter? https://pubmed.ncbi.nlm.nih.gov/24089109/

Bio:

Dr. Rob Leeper is an Assistant Professor in the Department of Surgery at Western University. He is an acute care and trauma surgeon with an interest in resuscitation, both inside and outside the operating room. He did residency in Western and went on to do a prestigious trauma fellowship at Johns Hopkins University. He is the father of 3 and a former college football player.

Dr. John C Alverdy (https://twitter.com/JCAlverdy?s=20) is a minimally invasive surgeon at the University of Chicago. He is an iconoclastic scientist whose research focuses on gut microbiome and its impact on surgical site infections. His lab is continuously NIH funded, with publications in Nature and many other high impact journals. More importantly, however, Dr. Alverdy is willing to challenge commonly accepted ideas, like the very basic tenet that we really know why anastomoses leak. He gave a fantastic talk this year at the American Society of Colon and Rectal Surgeons, and we’d highly encourage you all to listen to that well.

Links:

1. ASCRS distinguished lectureships. https://fascrs.org/my-ascrs/meetings-events/2021-annual-scientific-meeting/distinguished-lectureships

2. The gut microbiota and gastrointestinal surgery. https://pubmed.ncbi.nlm.nih.gov/27729657/

3. Re-examining causes of surgical site infections following elective surgery in the era of asepsis. https://pubmed.ncbi.nlm.nih.gov/32006469/

4. Serial Endoscopic Surveillance & Direct Topical Antibiotics to Define the Role of Microbes in Anastomotic Healing (SES-DTA). https://clinicaltrials.gov/ct2/show/NCT02682485

5. Alverdy lab website: https://wiki.uchicago.edu/display/surgery/Alverdy+Lab+Wiki

Bio (from University of Chicago surgery website):

John C. Alverdy, MD, performs a wide variety of complex minimally invasive and open gastrointestinal surgical procedures with decades of experience in the field. Dr. Alverdy is nationally recognized for introducing several new operations into the field, including minimally invasive pancreatic surgery, bariatric surgery, and surgery for disorders of the foregut including the esophagus and stomach.

Dr. Alverdy has also run a continuously funded NIH-funded laboratory that studies the molecular interactions of bacteria and the intestinal mucosa in order to understand how life-threatening infections arise after trauma and major surgery and during critical illness. He has developed several anti-infective polymer-based compounds that can attenuate the virulence of several multi-drug resistant pathogens that cause life threatening infections in surgical patients and works with the IME to synthesize, refine, and scale the compounds for pre-clinical testing.

Dr. Christopher "Chip" Doig is an intensivist at the Foothills Medical Centre in Calgary, Alberta, Canada. We focused on a number of ethical issues in the ICU, from donation after cardiac death to the idea of “futility”, and how to discuss that with patients and their families. Finally, we try to understand how Dr. Doig remains so fresh after all these years as an intensivist.

Links:

1. Resumption of Cardiac Activity after Withdrawal of Life-Sustaining Measures. https://www.nejm.org/doi/full/10.1056/NEJMoa2022713

2. Ethics roundtable debate: Patients and surrogates want 'everything done' – what does 'everything' mean? https://ccforum.biomedcentral.com/articles/10.1186/cc5016

3. The name of the dog. https://www.nejm.org/doi/full/10.1056/nejmp1806388

Biography (from U of C website)
Dr Christopher Doig (better known as Chip) graduated from the University of Saskatchewan (MD with distinction), trained in Vancouver and Calgary with specialization in Internal Medicine and Critical Care Medicine. He has additional training in clinical epidemiology and health care ethics. Dr. Doig is a tenured Professor in the Departments of Critical Care Medicine, Medicine and Community Health Sciences in the Cumming School of Medicine, University of Calgary. He is a past Department Head for Community Health Sciences, and immediate past head for the Department of Critical Care Medicine, He has held other leadership roles including as a President and on the Board of the Alberta Medical Association (AMA), the board of the Canadian Medical Association (CMA), and STARS (Shock, Trauma and Rescue Society).

Dr. Doig has been recognized with a number of local, provincial, national, and international awards. These include: the McLeod Distinguished Achievement Award for Faculty from the University of Calgary, AHS President’s Excellence Award in Quality Improvement for the provincial ICU delirium initiative (co-lead), AMA Medal for Distinguished Service (contributions to developing critical care in Alberta), CMA Dr. William Marsden Award in Medical Ethics, the E. Garner King Award from the Canadian Critical Care Society, The Royal Life Saving Society Bronze Benefactor Medal (for work with STARS), and the Global Sepsis Award (Alberta Sepsis Network) from the Global Sepsis Alliance.

Dr. Doig’s publications include in leading medical journals including Nature Medicine, New England Journal of Medicine, JAMA, Canadian Medical Association Journal, Academic Medicine and leading critical care journals including the American Journal of Critical Care Medicine, Critical Care Medicine, Intensive Care Medicine, and the Journal of Critical Care. Dr. Doig’s publications cover a breadth of translational medicine, clinical trials, outcomes-based research involving large cohorts and complex datasets, medical ethics, and medical education.

Dr. Doig’s experience provides a unique perspective on acute care delivery involving critically ill patients, quality improvement and patient safety, public engagement, and engagement with government on health policy issues. Dr. Doig is currently developing methods to evaluate physician performance Dr. Doig’s ongoing education includes enrolment in a Master’s in Health Economics (London School of Economics) and a Master’s of Public Policy (Harris School of Public Policy, University of Chicago).

Chip is most proud to be a father to 4 fantastic kids, and 30 years married to Suzanne. He enjoys time off in the mountains (biking, hiking and skiing), swimming, and playing soccer (currently ranked second in his family in goal scoring but hoping to improve). He is the Vogel Team Captain of Canadian National Medical Soccer playing at the World Medical Football Championships.

Dr. Elena Parvez is a surgical oncologist and Assistant Professor in the Department of Surgery. Her clinical expertise and research interests are in breast cancer. She is exploring breast cancer outcomes in refugees to Canada who have breast cancer. She has received funding from Canadian Institutes of Health Research (CIHR) to conduct a trial which identifies a strategy to avoid post-neoadjuvant radiation therapy in patients with locally advanced breast cancer who have a complete response to neoadjuvant chemotherapy.

She presented this work at the “Best of CSF Research 2023” session last year.

Join us at the upcoming CSF in Winnipeg!

https://www.canadiansurgeryforum.com/

Links:

1. Adjuvant radiation therapy among immigrant and Canadian-born/long-term resident women with breast cancer. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10718225/
2. https://experts.mcmaster.ca/display/parveze
3. https://www.canadiansurgeryforum.com/

Well the summer has come and gone and we’re back into the swing of things! We’re really excited that in a couple of weeks, many surgeons from across Canada will be meeting for our largest national conference, the Canadian Surgical Forum. This year it is in the lovely city of Winnipeg. It’s a time to catch up with friends and colleagues across the country, and to hear the amazing work that’s been going on. This is a teaser for the type and calibre of work that goes on at CSF. Dr. Elena Parvez presented this work last year at the best research of CSF 2023 session. Dr. Parvez is an assistant professor of surgery at McMaster University in Hamilton. Her clinical practice is in surgical oncology. In this episode, she presented her work on adjuvant radiation therapy among immigrant and Canadian-born women with breast cancer.

We look forward to meeting many of our listeners at CSF this year and we’ll be recording some interviews live at CSF. We’d love to hear your feedback and suggestion for content for the upcoming year. As always, you can also send your thoughts to [email protected].