Grants Funded

Abstract
Breast reconstruction using the free muscle-sparing transversus abdominus myocutaneous (TRAM) or deep inferior epigastric perforator (DIEP) flap are common methods for restoring mastectomy defects for breast cancer patients. Despite its increasing popularity and safety, the abdominal donor site remains a major source of postoperative pain. Adequate pain control is important as it has been shown to reduce serious medical complications, in-hospital death, shortens hospital stay, and lowers health-care costs. The current postoperative pain relief protocol consists primarily of a patient-controlled anesthesia (PCA) device delivering intravenous opioids. Opioids can cause numerous side-effects such as sedation, headache, nausea, vomiting, breathing difficulties, bladder and bowel dysfunction. A promising approach to provide postoperative pain control of the abdominal incision is the newly developed transversus abdominis plane (TAP) peripheral nerve block. Although the TAP block has been found to be an effective pain-relief following major abdominal surgeries, its use has never been studied for breast reconstruction using abdominal tissue. Therefore, we propose this study to rigorously test the effectiveness of a TAP catheter delivering continuous local anesthetic in reducing postoperative abdominal pain following abdominal tissue breast reconstruction. This study has significant potential implications in improving both clinical care and health outcomes in patients undergoing microsurgical abdominally-based breast reconstruction.

Biography
Dr. Toni Zhong is a graduate of the Plastic Surgery Residency Training Program at the University of Western Ontario and became a Fellow of the Royal College of Physicians and Surgeons of Canada in 2007. Dr. Zhong has won numerous national and international research and young investigator awards and is the recipient of numerous peer-reviewed research grants. Following the completion of her residency, Dr. Zhong was awarded the prestigious Zeiss Canada Microsurgery Scholarship to pursue a year-long Microvascular and Reconstructive Surgery Fellowship at Memorial Sloan Kettering Cancer Center in New York City. Dr. Toni Zhong B.Sc. M.D. FRCS(C) is a member in the Division of Plastic and Reconstructive Surgery at the University Health Network. In addition to her clinical interest in all forms of complex reconstruction post-oncologic ablation and treatment of difficult cutaneous malignancies, she is taking a leadership role in building the Breast Restoration Program at UHN as a center of excellence for breast reconstruction in North America. To complement her clinical practice in the field of reconstructive surgery, Dr. Zhong is currently pursuing her Masters of Science in Clinical Epidemiology at the Harvard School of Public Health. Her research areas of interest include the evaluation of innovative breast reconstruction surgical techniques, including the use of Alloderm in a multi-site randomized trial and development of validated patient-reported outcome instruments designed to evaluate health-related quality of life following specific breast surgical procedures.