During his more than 15-year tenure at Gillette Children’s Specialty Healthcare, craniofacial and plastic surgeon Robert Wood, MD, has treated more than 1,800 patients who have craniosynostosis, a condition that occurs when one or more of the joints in a baby’s skull closes too early. Children who have craniosynostosis might have an abnormal skull shape, an abnormal forehead shape, or asymmetrical eyes and/or ears. It is one of the most common physical deformities in infants, occurring in about one of every 2,000 births.
Except in the mildest of cases, the treatment for craniosynostosis requires surgery—usually when a child is between 4 and 6 months old. For Wood, the sheer volume of patients he’s seen has offered him opportunities to advance clinical care through his implementation of unique and groundbreaking surgical techniques.
One of the primary challenges of craniosynostosis repair surgery, also called cranial vault remodeling, is blood loss during surgery. Due to this, blood transfusions are routine in almost all craniosynostosis repair surgeries. For point of reference, the typical transfusion rate is 90 to 100 percent nationwide.
But to Wood, these numbers are far too high.
“Any time you are discussing pouring a stranger's blood into a patient, especially when that patient is an infant, you’re going to have some nervous parents,” Wood says. “It’s an added layer of complication and it’s worthwhile to think about. Some bloodborne infections, such as Hepatitis C, are still difficult to screen. Additionally, it’s not as if the rate of negative transfusion reactions is small.”
With this in mind, Wood has pioneered an approach to a transfusion-less craniosynostosis repair surgery. In 2015, Wood’s overall transfusion rate was just five percent, an 85 percent reduction from the national average.
While other craniofacial surgeons have experimented with low-blood-loss techniques for cranial vault remodeling, Wood is the first to consistently eliminate blood transfusions from craniosynostosis repair surgery.
“This technique benefits everyone involved,” Wood says. “For the family, it’s one less thing to worry about. On our end we’re conserving blood as well as cutting down on time spent in the operating room, which contributes to faster patient recovery.”
Donation, Plus Collaboration Creates Research Pilot Program
Wood and the Gillette team perform more craniosynostosis repair surgeries than all the other hospitals in the State of Minnesota combined, and this doesn’t always leave as much time to publish research as he would like. But one Gillette donor’s contribution is going to remedy that issue.
“We published a study on the success of our transfusion-less technique several years ago, but we’ve made additional progress in refining the procedure in the years since,” Wood says. “We needed someone who could update the data, and the donation allowed my colleague Paul Lim, MD, to create a pilot program that would give one bright resident from the University of Minnesota Medical School the opportunity to do just that.”
Wood and Lim offered participation in the program to Chris Stewart, MD, a plastic surgery resident who scored highest among UMN Medical School residents in the Annual Plastic Surgery In-Service Exam.
“When I found out about this opportunity, I was obviously excited because as a plastics resident you’re generally not going to see a lot of the highly specialized craniofacial work that Dr. Wood and his team are doing,” Stewart says. “As a medical student and now as a resident, there is an emphasis on being exposed to a lot of different things and finding where your passion in medicine lies. Getting the chance to participate in updating and presenting this research, all while working with the world-class surgical team at Gillette, it’s the type of experience that I know will make me a better doctor as I move forward in my career.”
Wood is thankful for the generous donation that made this pilot program possible, and he hopes that similar contributions will help the initiative going forward.
“I think a lot of people who don’t work in medicine might be surprised by how important this kind of collaboration plays in the process. That’s what we have with this program. It’s a union of multiple medical organizations and individuals that philanthropy made possible,” Wood says.
“The new pilot program is a mutually beneficial relationship, and we’re really excited to have Chris on the team,” Wood adds. “He gets the benefit of spending time around surgeons with a great deal of talent and experience, along with strengthening his resume by publishing the research, and we get our transfusion-less technique in front of more surgical specialists in the medical field. Everyone should benefit from the knowledge we’ve gained, and hopefully sharing our findings will lead to greater understanding and enhance the care of patients all over the world.”
To support other critical research initiatives at Gillette Children’s Hospital Foundation, contact Janet Hallaway at 651-325-2338 or JanetHallaway@gillettechildrens.com.