The fellowship has been in existence since 2009. The fellowship began as a 6-month fellowship and has progressed into a one-year fellowship. Since its inception, eight (8) individuals have completed the program.
The requirements for the fellowship include completion of an approved residency in plastic surgery, USMLE parts 1, 2 & 3 and you must qualify for licensure in Wisconsin.
Goals and Objectives
- Regardless of the defect, after completion of this fellowship, the fellow will be able to examine a defect of the head and neck, trunk or extremities and be able to provide at least three options for reconstruction of these defects.
- The fellow will be familiar with the principles of microsurgery and recognize the mechanism and consequences of the no re-flow phenomenon, know how to treat a failing flap and know the processes by which a failing flap can be evaluated and potentially salvaged.
- The resident will understand the technologic, pharmacologic, and physiologic principles and postoperative monitoring of free flaps.
After completion of the MCW Fellowship in Microsurgery fellows will be able to:
- Identify patients with defects through injury or other disease processes that are flap candidates, as well as know the anatomy for harvesting the most common free flaps.
- Recognize anatomic problems that would limit or alter the patient's ability to undergo a microsurgical procedure.
- Explain the preoperative workup necessary to perform microsurgical procedures of the head and neck, trunk or extremities.
- Describe the steps of the procedure and the details of a secondary procedure, if there is an intraoperative flap failure.
- Manage intraoperative flap thrombosis, arterial and/or venous, immediate or delayed, partial and/or full-thickness flap necrosis.
- Apply skills in the laboratory (depending on availability) on a cadaver.
- Sharpen microsurgery skills in plastic surgery laboratory.
- Master the basic microsurgical techniques, including microneural repair and microsurgical anastomosis.
- Know the basic physiology of nerve injury and of nerve healing.
- Be familiar with the use of the operating microscope, and understand the indications and contraindications, as well as the techniques for accomplishing re-implantation of amputated parts.
The goals and objectives for our trainees in the Medical College of Wisconsin Reconstructive Microsurgery Fellowship include a broad range of direct clinical experience in the reconstruction of acquired mastectomy defects following breast cancer surgery, the reconstruction of head and neck deformities following the ablation of head and neck cancer, the reconstruction of sarcoma resections throughout the body, the reconstruction of paralytic problems with the use of free functional muscle transfer, and the reconstruction of lower extremity deformities and wounds following vehicular trauma.
The teaching staff includes John LoGiudice, MD, FACS, Hani S. Matloub, MD, FACS and Patrick Hettinger, MD.
The training site is Froedtert Hospital.
The clinical components of the training program have been described in the Goals and Objectives. The research component includes opportunities throughout the range of clinical reconstructive microsurgery. This would include clinical opportunities for research work in the areas of breast cancer reconstruction, sarcoma reconstruction, reconstruction of traumatic deformities and the reconstruction of paralytic defects following ablative surgery or congenital abnormalities.
The trainee's supervisory and patient care responsibilities include coordinating with the chief resident of the Plastic and Reconstructive Surgery Service at Froedtert Hospital, providing operative care to those patients, follow up, rounding on the patients while in hospital and then preoperative and postoperative evaluation and management within the clinic setting.
Clinical procedural requirements include participation in a broad range of microvascular and regional reconstructive procedures with direct operative involvement.
Didactic sessions and teaching methods to ensure that a broad exposure to the world of reconstructive microsurgery includes mandatory attendance at a preoperative indications conference with participation in preoperative discussions, including the entire MCW Plastic Surgery faculty, mandatory participation in Plastic Surgery Grand Rounds, including the delivery of one Grand Rounds lecture on any topic within the realm of reconstructive microsurgery, and participation in a monthly Journal Club covering a broad range of reconstructive microsurgery topics, largely derived from the Journal of Plastic and Reconstructive Surgery, Annals of Plastic Surgery, and the Journal of Microsurgery.
The trainee is directly mentored and supervised by all of the faculty involved, with specific meetings for formal evaluation with Dr. John LoGiudice at 3-month intervals throughout the training year.