The Plastic Surgery Foundation
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Grants We Funded

Grant applicants for the 2022 cycle requested a total of over $2.9 million dollars. The PSF Study Section subcommittees of Basic & Translational Research and Clinical Research evaluated 115 grant applications on the following topics:

The PSF awarded research grants totaling almost $550,000 to support 19 plastic surgery research proposals.

ASPS/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.

Research Abstracts

Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area or PSF funding mechanism.

Impact of Treatment Variation for Deep Sternal Wound Infection

Principal Investigator
Erika Sears MD


The Regents of the University of Michigan

Funding Mechanism
National Endowment for Plastic Surgery Grant

Focus Area
General Reconstructive

Deep sternal wound infection following cardiac surgery is a devastating complication resulting in high
mortality, prolonged hospital stays, and significant cost burden. Rates of deep sternal wound infection have
failed to improve in the last 30 years, despite national initiatives to reduce surgical site infections in patients
undergoing cardiac surgery. Furthermore, there is considerable variability in the treatment options for deep
sternal wound infection. For example, some centers advocate for early debridement and flap coverage in
the treatment of deep sternal wound infections, whereas others routinely avoid flap closure in favor of
prolonged negative pressure therapy. In addition, the time to definitive closure varies among centers. To
date, robust evidence to support a single treatment strategy is sparse, and there are few opportunities to
study deep sternal wound infections on a population-based level. Understanding the patient, provider, and
system-related factors that influence the treatment and outcomes of deep sternal wound infections can
potentially improve the care of these complex patients and can provide insight into the most effective and
efficient treatment options.
The goal of this proposal is to examine variation in the care of deep sternal wound infections in the United
States, specifically the timing of operative intervention and the use of vascularized flaps for closure, and its
influence on patient outcomes and treatment costs. To study this, we will analyze the Marketscan
Commercial Claims and Encounters Database and Medicare Supplemental Database from Truven Health
Analytics. This population-based dataset represents the largest collection of employer-based national claims
data in the United States, and contains individual-level longitudinal claims data from inpatient, outpatient,
and pharmacy settings from large employers, managed care organizations, hospitals, and Medicare
programs. This data will allow us to address the following specific aims: 1) to evaluate the effect of timing of
treatment and use of flap transfer on patient outcomes, 2) to evaluate the impact of provider and hospital
characteristics on treatment timing and use of flap transfer, and 3) to evaluate the impact of treatment timing
and use of flap transfer on expenditures for patients with deep sternal wound infection. The findings from
this study will guide plastic surgeons seeking the most effective strategies to manage this difficult
complication following cardiac surgery, as well as influence policy makers interested in identifying costeffective
pathways for the treatment of these patients.

Erika D. Sears, MD, MS, serves as an Assistant Professor in the Section of Plastic Surgery at the University of Michigan Health System. At VA Ann Arbor Health Care System, she is a Staff Physician in Plastic Surgery and a research investigator in the VA Center for Clinical Management Research. Dr. Sears received her Bachelors of Science in Biomedical Engineering from Northwestern University and Doctor of Medicine from the University of Michigan Medical School. She completed the Integrated Plastic Surgery Residency and Hand Surgery Fellowship at the University of Michigan. She also received additional research training in health services research as a fellow of the Robert Wood Johnson Clinical Scholars Program where she earned a Master of Science degree in health services research from the University of Michigan Rackham Graduate School. Dr. Sears has published 32 peer-reviewed manuscripts and 15 book chapters. Her research interests include the study of practice variation in hand and plastic surgery and its influence on patient outcomes and resource utilization. Her research is dedicated to finding strategies to improve the efficiency and value of surgical care. With grant support from the PSF, Dr. Sears will conduct a national study of the impact of pre-operative mammography use on the efficiency and value of breast reduction surgery.