Miss Tania Cubison MBBS, FRCS, FRCS(Plast)

Specialist in cosmetic surgery, burn care and scar revision.  
Tania Cubison is one of a very small number of female plastic surgeons
in the South East of England

McIndoe 
Surgical Centre

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CURRICULUM VITAE

of

Lt Col Tania Clare Strange Cubison

MBBS FRCS FRCS (Plast) RAMC

Consultant in Burns and Plastic Surgery

PERSONAL DETAILS

NAME                                               Tania Clare Strange CUBISON,   (married name HARPER)

ADDRESS                                         c/o McIndoe Surgical Centre
                                                            Holtye Road

                                                            East Grinstead

                                                            RH19 3EB

TELEPHONE                                  Secretary (Nicky) 07879 895685

E-MAIL                                            taniacubison@uk-consultants.co.uk

MARITAL STATUS                       Married

MILITARY STATUS                     Commissioned into the Army 1988. Currently on Full Regular Commission serving in the            rank of Lt Col in the Royal Army Medical Corps

GENERAL MEDICAL COUNCIL                            3539163                Specialist Register for Plastic Surgery

MEDICAL DEFENCE UNION                                  269618E             

QUALIFICATIONS

MBBS                                                JULY 1991

University of Newcastle–Upon-Tyne Medical School,

FRCS                                                 NOVEMBER 1997

Royal College of Surgeons of England

FRCS (Plast)                                    SEPTEMBER 2006

Royal College of Surgeons of England

PRESENT POST

Consultant Burns and Plastic Surgeon – Queen Victoria Hospital, East Grinstead

Consultant Advisor in Burns and Plastic Surgery to the Director General Army Medical Services.

Honorary Clinical Senior Lecturer at University of Sussex, Brighton and Sussex Medical School.

I am currently employed as Consultant in Burns and Plastic Surgery at the Queen Victoria Hospital East Grinstead, having taken up this appointment in February 2008. My Special Interests are in Burns and Lower Limb reconstruction and the surgical management of amputees.  I also have a particular interest in scarring disfigurement relating to trauma and burn injury, and also manage acute burn injury patients. I have a special interest in burn injury in children and am actively involved in Child Protection Issues.

PREVIOUS APPOINTMENTS

MEDICO-LEGAL EXPERIENCE

Since 2008 I have been involved with preparation of Medico-Legal Reports and providing Expert Witness services for both Civil and Criminal proceedings. My main areas of experience are in scarring, burns and lower limb injury. I am the Clinical Lead for Child Protection in the Burns Unit at the Queen Victoria Hospital, East Grinstead and have been involved in the legal process for many of these difficult cases.
PLASTIC SURGERY TRAINING

General Plastic Surgery

During my first 4 years of plastic surgery SpR training I worked for a number of consultants, with a wide variety of surgery interests, these have included acute burns, hand surgery, breast reconstruction, head and neck surgery, secondary burn reconstruction and general plastic surgery. I took part in an on-call rota and was part of a variety of emergency procedures. I became confident to perform the majority of hand surgery cases including open fractures and replantation, and was also part of the team for more major cases such as a two level arm replant.

For part of my fifth and sixth years I had the opportunity to work in a split role. Focusing on the areas that I felt would be of most benefit to ensure a fully rounded training. I undertook a part time aesthetic fellowship at the McIndoe Surgical Centre, whilst also continuing for the other sessions in a supernumerary role as an additional microsurgical fellow/ senior registrar at the Queen Victoria Hospital. During this period I was able to work with a number of consultants and was able to undertake more complex procedures on parallel lists, allowing me to take a more responsible role, and to build up my confidence in procedures such as breast reconstruction with Latisimus Dorsi and  TRAM/DIEP flaps. As a part time Aesthetic fellow I attended the McIndoe Surgical centre for 2 days a week, and also visited Falkham Manor Hospital regularly. I attended clinics, sitting on new patient consultations and follow up visits. I visited patients on the ward pre and post operatively and assisted a number of aesthetic procedures, including face and neck lifts, endoscopic brow lift, blepharoplasty and rhinoplasty.

During my training I developed an interest in Laser treatments and was awarded the BTEC in Skin Laser Technology, Treatment and Applications.

I was involved in clinically based research, and the pursuit of evidence based practice in everyday burn care. I have travelled to many meetings to present my work and have been  invited to be a chairman for sessions at the 10^th Congress of the European Society of Plastic, Reconstructive and Aesthetic Surgery in Vienna in August 2005 and at the British Burn Association Meetings since 2008. I have also reviewed papers on both hand surgery and burns.  During year 6 I worked with the Research department at the Queen Victoria Hospital to put together a new research strategy.

Lower Limb Reconstruction

As a medical student I was able to visit the Med Star Unit at the Washington Hospital Centre as part of my elective at the American Forces Medical School in Bethesda USA, and was initially planning to be a Trauma surgeon. I have retained an interest in leg trauma during my general surgery training. While a Senior registrar/Microsurgery fellow at the QVH I was able to further develop my interest in lower limb trauma and its reconstruction. I had my own weekly lower limb trauma list, and carried out a number of free tissue transfer procedures for open tibial fractures (with senior consultant input where needed).  I was also able to perform procedures at other hospitals as part of a multidisciplinary team. I attended the Charing Cross Lower limb trauma course in June 07, and have now taken on the role of lower limb trauma clinical lead, facilitating the early transfer of these often difficult cases. I still lead the lower limb trauma team  MDT meeting assisted by Nora Nugent and my trauma outreach nurse practioners , and I have a monthly joint clinic working with a local orthopaedic colleague.

Burn Care

I have a special interest in burn care and I have spent a significant amount of time working with burn patients   in 4 centres, both acutely and during long term reconstruction programmes. I have spent time trying to improve the pre-burns centre management of patients by introducing a new transfer proforma and modifying this over nearly 10 years, and I have also been involved in collecting epidemiological information to try and improve both resourcing of burn care and prevention of burn injury. During my burn fellowship I co-ordinated the clinical and screening components of an outbreak of PVL Toxin producing MRSA, and have furthered my knowledge both in the practical clinical and managerial aspects of this problem.

I have developed practical skills in assessment of burn injury, resuscitation and acute surgical intervention including escharotomy, excision techniques and split skin grafting. I have also been involved in secondary burns reconstruction using a variety of techniques including local flaps, tissue expansion, and specialist composite or hair bearing grafts as well as newer techniques of resurfacing, with skin substitutes and the use of biological dressings.

My last training post allowed me to be involved in burn care at a senior level, assessing and planning treatment for very complex acute burn patients, and also to understand the managerial aspects of being a burn consultant.

In January 08 I was able to visit the Shriners Hospital for Burnt Children in Galveston, Texas. I was able to observe the acute management of a large number of very severe burns (all over 40% body surface area) in children in a large well structured multidisciplinary team with a huge research facility. While in Texas I was also able to visit the American Military Burns facility at the Brooke Army Medical Centre in San Antonio and the Institute of Surgical Research. I was made very welcome by the American Burn Teams and hope to return in the future.

Military Plastic Surgery Training

I have undergone significant training since taking up my consultant post in military aspects of plastic surgery. This has included secondments to the clinical team in Birmingham, and specialist courses in military operational surgical techniques as well as other pre-deployment training for Afghanistan. I have now deployed with Herrick 13B (February – April 2011) and 16A (May – July 2012) as stand-alone Plastic Surgery Consultant in a 10 surgeon operating team, and have gained significant experience in soft tissue management as well as the management of acute maxillo-facial and ophthalmic injury. During this period I have developed and consolidated significant skills in team working within an international extended multi-disciplinary team.

CAREER AIM

I have now achieved my aim to become a military Plastic Surgeon, maintaining my special interests in burns, trauma reconstruction and the surgical management of amputees, and now work between Queen Victoria Hospital in East Grinstead and the Defence Rehabilitation Centre at Headley Court. I hope to be formally posted to DRMC Headley Court in the next year to consolidate my links with the unit.

I plan to continue to work in a busy Burns Centre looking after patients with acute burns, planning long term rehabilitation and being actively involved with the training of all levels of military personnel in the prevention and management of burn injury. I hope to continue to work with the British Burn Association to ensure that all deploying personnel have access to a military run Emergency Management of Severe Burns Course and update training where appropriate. I would also like to continue my interest in lower limb trauma, heterotopic ossification and microsurgery, working to provide optimal long term care for injured soldiers.

AWARDS and PRIZES

Newcastle University Medical School Special Study Prize for a Project on External Fixation- Aug 90.

Montefiore Bronze Prize for General Surgery - Nov 92 (Military Prize).

Royal Society of Medicine Plastic Surgery Case Presentation prize 1996

Queen Victoria Hospital Clinical Audit Awards 2001 – 2^nd Prize

British Burns Association Presentation Prize 2002

McGregor Medal FRCS (Plast) -  Sept 2006

St Andrews (Hackett) Audit Prize – Oct 07

Health and Social Care Award, Innovations in Acute Care 09, Regional Winner and National Runner up

PLASTIC SURGERY COURSES

Northwick Park Microsurgical Course April 99

Skills Course in Hand Surgery – RCS Jun 01

Emergency Management of Severe Burns Course – Edinburgh  02

Radiation Protection and use of the Image Intensifier – East Grinstead Mar 02

Emergency Management of Severe Burns Instructors Course – Birmingham May 02

Child Abuse Training Day – East Grinstead May 03

Instructional day in Aesthetic Plastic Surgery – RSM May 03

Doctors on Trial – East Grinstead June 03

Laser Training Day – East Grinstead June 03

Mini fragment workshop – Derby July 03

BTEC Laser – Nottingham May 04

Critical Care of the Burnt Patient – London Jan 05

Fundamental Techniques in Burn Reconstruction – London Feb 05

Plastic Surgery in Times of Trauma – London Mar 05

BAPS Educational Course in Plastic Surgery I – Manchester  May 05

BSSH Educational Course in Hand Surgery  II – Manchester  Jun 05

BAPS Educational Course in Plastic Surgery II – Manchester Sept 05

Edinburgh Hand Course – Edinburgh Jan 06

BSSH Educational Course in Hand Surgery  III – Manchester  Feb 06

BAPS Educational Course in Plastic Surgery III– Manchester Mar 06

BSSH Educational Course in Hand Surgery  IV – Manchester  Jun 06

FRCS Plast Revision Course – Canniesburn July 06

FRCS Plast Mock Exam Study Day – Norwich Sept 06

Lower Limb Trauma/Open Tibial Fractures – Charing Cross June 07

Botox and Fillers Training Course – Buckinghamshire – May 2010

 NON PLASTIC SURGERY COURSES

Advanced Trauma Life Support Course  and Advanced Cardiac Life Support Course - USA July 89.

Battlefield Advanced Trauma Life Support  Sept 92.

Advanced Course in Military Medicine for Medical Officers - Int Com of Mil Med - South Africa 94.

Practical Field Surgical Training Course - Denmark May 95.

Maxillo Facial Trauma Study Day  - Royal College of Surgeons  Mar 96

Anastomosis Workshop -  Royal Army Medical College  Dec 96

FRCS Part II Written and Practical Courses Apr 97, Apley Orthopaedic Course for FRCS Sept 97

Paediatric Advanced Life Support – East Grinstead June 99, Emergency Obs and Gynaecology – Gosport Nov 00

Military Operational Surgical Techniques - Royal College of Surgeons Jul 09

Military Operational Surgical Techniques - Royal College of Surgeons Dec 10

Other military courses in instructional techniques, first aid instruction, casualty simulation etc.

Annual Military Mandatory Training and  pre deployment training.

PUBLICATIONS

1.      External Fixation of Lower Limb Fractures in Children (RJH Gregory , TCS Cubison, IM Pinder and  SR Smith.) The Journal of Trauma. Nov 92 Vol 33 No 5. 691-3

1.a - The Pre-Burns Unit Management of the Burnt Patient  (TCS Cubison and HL Ashworth) Published in Abstract . Emergency Medicine July 99.

2. Warming Milk : A preventable cause of scalds in children (SLA Jeffery, TCS Cubison, C Greenaway, PM Gilbert and N Parkhouse) British Medical Journal. Jan 00 Vol 320 No 7229. 235

3.Treatment before transfer: the patient with burns (HL Ashworth, TCS Cubison, PMGilbert, and KM Sim) Emergency Medical Journal  (prev Journal of Accident and Emegency Medicine). Sept 01 Vol 18 349-351

4. Lasagne: A simple model to assess the practical skills of split skin graft harvesting and meshing. (TCS Cubison, T Clare) British Journal of Plastic Surgery Jan 03 Vol 55/8 703-704

5. The Principles of Plastic and Reconstructive Surgery, Chapter 22. Military field surgery text book. (TCS Cubison, AD Malyon) HMSO  2003

6. The Domestic Washing Machine: a common cause of electrical burn (N Nicolaou, D Humzah,

TCS Cubison, PM Gilbert) European Journal of Plastic Surgery (2004) 26:422-424
7. Colour Coding for Hand Rehabilitation (TCS Cubison, MHM Seath, HJCR Belcher)

Annals of Royal College of Surgeons 2004 Vol 86 (4) 306

8. So much for percentage, but what about the weight? (TCS Cubison, PM Gilbert)

Emergency Medical Journal 2005, Vol 22 (9) 643-645

9. Chapter 12.  Scar Revision. : In Plastic Surgery the Second Edition (Ed Mathes)

A Chapter for the new edition of the text book previously known as McCarthy

(N Parkhouse TCS Cubison, D Humzah,) – WB Sauders, Dec 2005

10. Dermal Preservation using the Versajet^® Hydrosurgery System for Debridement of Paediatric Burns (TCS Cubison, SA Pape, SLA Jeffery ) - Burns 2006 Vol 32 (6) 714 -720

Response to comments by Dr Gravante and collegues ( re article: Dermal Preservation using the Versajet^® Hydrosurgery System for Debridement of Paediatric Burns) ,  TCS Cubison – Burns 06

11. Evidence for the link between healing time and the development of hypertrophic scars (HTS) in paediatric burns due to scald injury  .(TCS Cubison, SA Pape, N Parkhouse). Burns 2006 Vol 32 (8)  992 - 999.

12. The impact of recent legislation on paediatric fireworks injuries in the Newcastle upon Tyne region. (AF Edwin, TCS Cubison, SA Pape). Burns. 2008 Nov;34(7):953-64. Epub 2008 Jun 3.

13. Pediatric superficial scald burns – reassement of our follow-up protocol.

Egro FM, O'Neill JK, Briard R, Cubison TC, Kay AR, Estela CM, Burge TS.

J Burn Care Res. 2010 Jan-Feb;31(1):196-9.

14. How would you like your tea, vicar?  Jamnadas-Khoda B, See MS, Cubison CT, Dheansa BS.

Burns. 2010 May;36(3):356-9. Epub 2009 Jul 7.

15. Fast response letter on frostbite – BMJ; Cubison TCS, Hallam MJ February 2010

16. Managing frostbite. Hallam MJ, Cubison T, Dheansa B, Imray C.

BMJ. 2010 Nov 19;341:c5864.

17. Shaping the military wound: issues surrounding the reconstruction of injured servicemen at the Royal Centre for Defence Medicine. Evriviades D, Jeffery S, Cubison T, Lawton G, Gill M, Mortiboy D. Philos Trans R Soc Lond B Biol Sci. 2011 Jan 27;366(1562):219-30.

18. Invited Author.  Chapter 29 : Fundamentals Plastic Surgery for Fundamentals of Surgical Practice (3^rd Edition) an MRCS Handbook. Edited by Kingsnorth and Bowley. Cambridge University Press 2011

19. The "Tokyo" consensus on propeller flaps.

Pignatti M, Ogawa R, Hallock GG, Mateev M, Georgescu AV, Balakrishnan G, Ono S, Cubison TC, D'Arpa S, Koshima I, Hyakusoku H.

Plast Reconstr Surg. 2011 Feb;127(2):716-22.

19. The tertiary management of pretibial lacerations.

Lo S, Hallam MJ, Smith S, Cubison T.

J Plast Reconstr Aesthet Surg. 2012 Sep;65(9):1143-50. Epub 2012 Jan 24.

PRESENTATIONS

1.  A Case of Nasal Reconstruction ..TCS Cubison and N Parkhouse 

Royal Society of Medicine in London Nov 96. Awarded the presentation prize.

2. East Grinstead Burns Unit Database and Clinical Governance . TCS Cubison

Invited Speaker British Burn Association:  Apr 99

3. The pre burns unit management of the burnt patient. TCS Cubison, HL Ashworth, K Sim and PM Gilbert. The 2nd Trauma Care Conference . June 99

4. Treatment before transfer, the burnt patient. TCS Cubison, HL Ashworth, K Sim and PM Gilbert

 Tri-Service Surgical meeting Oct 00

5. Burn Resuscitation . TCS Cubison. Instructional meeting on the management of burns.  Stoke Mandeville Feb 01

6. An overview of two years of the East Grinstead database, TCS Cubison and SM Booth

 British Burn Association April 01

7. Improving pre-burns centre management: the introduction of a new transfer proforma. TCS Cubison  A.Pirayesh  WY Li,  HL.Ashworth. K.Sim, PM Gilbert. Trauma Care, Edinburgh  Jun 01

and European Burns Association Lyon Sept 01

8. The epidemiology of burns from the first two years of the East Grinstead database.

TCS Cubison  S.Booth and P M Gilbert. European Burns Association Lyon Sept 01

9. Major petrol burns: Outcome in 20 patients vs non-petrol-related burns, treatment algorithm and literature review. A Pirayesh, TCS Cubison, BM Richard,  MI James and PM Gilbert

European Burns Association Lyon Sept 01

10. Composite auricular cartilage grafts to reconstruct the philtrum of the upper lip after burn injury.

TCS Cubison and N Parkhouse. British Association of Plastic Surgeons Winter Meeting 2001.

11. So much for percentage, but what about the weight? TCS Cubison, PM Gilbert

Tri Service surgical meeting Mar 2002

12. Surgical complications in the MDHUs….. are we truly recording them? AN Pandya, TCS Cubison, GV Scerri. Tri Service surgical meeting Mar 2002

13. So much for percentage, but what about the weight? TCS Cubison, PM Gilbert

British Burn Association May 02 Awarded the best presentation prize.

14. Military Plastic Surgery Provision, Who will care for the next generation of Guinea Pigs?

TCS Cubison, A Willman, P Roberts, GV Scerri .BAPS Winter Meeting 2002.

15. Paediatric Scalds: An Audit of Current Practice and presentation of suggested guidelines for follow up of scalds over 5% TBSA.TCS Cubison, O Harley, PM Gilbert. BBA April 03

16. Plastic Surgery Under the New Deal. TCS Cubison, J Skillman, JW Blair, KW Cullen

British Association of Plastic Surgeons Summer Meeting 2003.

17. Telemedicine as an adjunct to the Pre-Burns Centre Management of the burnt patient

TCS Cubison, D Wallace, PM Gilbert. Poster European Burns Association Meeting , Norway Sept 2003, British Burn Assoc April 04 and International Society of Burn Injury, Yokohama Japan Aug 04

18. A Comparative Audit of the Management of Paediatric Scalds in two British Burn Centres

TCS Cubison, M Kernohan, M Warden, ND Athey, CA Reid, PM Gilbert. BBA April 04

19. The Tea Scald, A Homogenous Injury? TCS Cubison, A Bangash, PMGilbert

Poster  BBA April 04 and International Society of Burn Injury, Yokohama Japan Aug 04

20. Chemical burns in a toddler, an unusual aetiology.  S Donnelly, TCS Cubison and CA Reid

Poster  BBA April 04 and International Society of Burn Injury, Yokohama Japan Aug 04

21. A Comparative Audit of the Management of Paediatric Scalds in two British Burn Centres

TCS Cubison, M Kernohan, M Warden, ND Athey, CA Reid, PM Gilbert

International Society of Burn Injury, Yokohama Japan Aug 04

22. Mass Casualty Planning in Burn Disaster, TCS Cubison, presentation of surgical forum

International Society of Burn Injury, Yokohama Japan Aug 04

23.Burns Disaster – The military role, TCS Cubison

Combined Services Plastic Surgical Society Oct 04

24. Long Term Outcome of Scald injury. TCS Cubison

Northern Regional Burns Network Annual Study Day Nov 04

25. A Model for fracture fixation. V Agrawal ,TCS Cubison, , B Crowley, RH Milner

British Society for Surgery of the Hand Nov 04

26. Practical Training in Fracture Fixation, a simple solution,

TCS Cubison, V Agrawal, B Crowley, RH Milner, BAPS Winter Meeting  04

27. Long-term Outcome of paediatric scald injury- a multidisciplinary approach. Epidemiology and Selection Issues. TCS Cubison, A Ponniah, A McKenzie, F Toland, L Johnson, L Sanger, CA Reid

Oral Presentation British Burn Association April 05

28. Multidisciplinary follow up of paediatric scalds – therapy and psychosocial perspectives.

F Toland, L Sanger ,TCS Cubison, A McKenzie, A Ponniah, L Johnson, , CA Reid

Oral Presentation British Burn Association April 05

29. Multidisciplinary follow up after scald injury – Outreach Issues and conclusions

TCS Cubison, A McKenzie, A Ponniah, F Toland, L Johnson, L Sanger, CA Reid

Oral Presentation British Burn Association April 05

30. Gunpowder treason and plot: Bonfire and fireworks injuries – are current prevention strategies enough? A Edwin, TCS Cubison, CA Reid. Oral Presentation British Burn Association April 05

31. Tisseel fibrin sealant for skin graft application in burns.A Stannard, TCS Cubison, SLA Jeffery

Oral and video Presentation  at ESPRAS  Vienna  Sept 05 also as Poster BBA April 05

32. Versajet hydrosurgery for paediatric burn debridement. TCS Cubison, SLA Jeffery

Oral and video Presentation to ESPRAS  Vienna  Sept 05 also as Poster BBA April 05 and oral presentation to Combined Services Plastic Surgery Meeting Oct 05.

33.  Contact Dermatitis Presenting as an acute chemical burn. S Alam, F Nor, TCS Cubison

Poster British Burn Association April 05 and Poster European Burns Association Portugal 05

34. Assault by Salbutamol inhaler. DE Barnes, TCS Cubison, SLA Jeffery

Poster British Burn Association April 05 and Poster European Burns Association Portugal 05

35. A ten year review of paediatric firework injuries – The impact of legislation.

AFL Edwin, TCS Cubison, CA Reid. Oral Presentation  ESPRAS  Vienna  Sept 05

36. Paediatric bonfire injury in Newcastle in November, can we prevent it?

AFL Edwin, TCS Cubison, A Bangash, CA Reid, SLA Jeffery, PM Gilbert

Oral Presentation  ESPRAS  Vienna  Sept 05

37. Laser Doppler Imaging in the Burns Operating Theatre. TCS Cubison, AFL Edwin,AR Lecomber, SLA Jeffery , SA Pape. Poster Presentation European Burns Association Portugal Sept 05

38. Versajet– A New Tool To Aid In The Application Of Biological Dressings. TCS Cubison, AFL Edwin, SLA Jeffery , SA Pape. Poster Presentation European Burns Association Portugal Sept 05

39. The Medical Photographer- A Vital Part Of The Multidiscipinary Burns Team

TCS Cubson, K Guy,  SA Pape. Oral Presentation European Burns Association Portugal Sept 05

40. Management of burn in a patient with variegate porphyria. NH Alam, AJ Ramsden, TCS Cubison, SA Pape Poster Presentation European Burns Association Portugal Sept 05

41. Our experience with the Versajet hydrosurgery system in paediatric burns.AFL Edwin, TCS Cubison, SLA Jeffery , SA Pape. North East Plastic Surgery Meeting Middlesborough Jan 06

42. Defining the Role of Versajet Hydrosurgery in the burn patient – Our first 100 cases.

AFL Edwin, TCS Cubison, SLA Jeffery. BBA Dublin April 06.Poster for Summer BAPS 2006

43. Maintaining improvements and highlighting problems: a further audit of the east grinstead transfer proforma. T C S Cubison, R Taghizadeh, C E Anderson, B S Dhensa, P M Gilbert. .

British Burn Assoc Swansea Apr 2007, European Burn Meeting Budapest Sept 2007,

British Trauma Soc Nottingham Oct 2007.

44. Are Paediatric Bonfire and Firework Injuries in Newcastle upon Tyne Preventable? AFL Edwin, R Saharia, TCS Cubison, SA Pape and RH Milner,

British Burn Assoc Swansea Apr 2007, European Burn Meeting Budapest Sept 2007

45. A simple three-dimensional training aid for burn percentage assessment. TCS Cubison, SA Pape.

British Burn Assoc Swansea Apr 2007, European Burn Meeting Budapest Sept 2007,

46. Scar outcomes after the application of biological dressings : results of a randomised controlled study into scald healing in children. T C S Cubison, A Edwin, M Kernohan, S L A Jeffery, B S Dhensa, and S E James. European Burn Meeting Budapest Sept 2007

 47. Pustules, vesicles or odd lesions – do these matter in burn patients?

An outbreak of panton valentine leukocidin (PVL) – MRSA in a british burn centre

T.C.S.Cubison, E.L. Teare, R.V.Martin, M. Reacher, S. Millership, O Shelley and P Dziewulski. British Burn Assoc Bristol Apr 08

48. Manageing an outbreak of panton valentine leukocidin (PVL) – MRSA in a burn centre

E. L. Teare, T.C.S.Cubison, R.V.Martin, M. Reacher, S. Millership, O Shelley and P Dziewulski. Poster British Burn Assoc Bristol Apr 2008

49. Aesthetic and Functional outcome of Achilles tendon reconstruction with a single composite free ALT and vascularised Fascia Lata flep. D Ng, D,Dionyssiou, I Heppenstall, TC Teo, T Cubison. 9^th Congress of European Federation of Societies for Microsurgery. Finland June 08.

50. The use of Versajet® and the Laser Doppler Imager in the operating theatre to direct the early management of paediatric burn injury. The single procedure approach. TCS Cubison, BD Dhensa, PM Gilbert. Int Soc of Burn Injury Meeting, Montreal, Sept 08

51. Evidence for the link between healing times and patient age for hypertrophic scar formation in adult burns, R Shelley, TCS Cubison. Int Soc of Burn Injury Meeting, Montreal, Sept 08

52. The Use of Laser Doppler Imaging (LDI) in the assessment of burns within the first 48 hours of injury. S Tay, TCS Cubison, P Dziewulski. S Pape. Int Soc of Burn Injury Meeting, Montreal, Sept 08

53. London Trauma and Pre Hospital Care conference Nov 08 – Invited speaker on Major Burns

54. Trauma Care Conference May 09 – Invited speaker on burns and session chair

55. Invited Guest Speaker on Burns Scars at the National Meeting of Pressure Garment Technicians May 09

56. Invited Speaker on Lower Limb Reconstruction for the West Midlands plastic surgery training course – Birmingham Oct 09

57. Invited Guest Speaker – Royal Soc Medicine Mar 10 – Military and Civ Burns and Trauma.

58. Invited Speaker – National Conference of ODPs  -Manchester May 10 – Telemedicine

59. Invited Guest Speaker – Orthopaedic Regional Circuit Meeting – Canterbury Jul 10 – HO and military trauma.

60. Invited Guest Speaker – Maxillo Facial Travelling club of Great Britain  – East Grinstead Nov 10 – Managing the military wound.

61. Invited Guest Speaker –Regional Anaesthetic Training day – Redhill  Feb 11 – Managing the military wound.

62. If you want to be a surgeon join an army! Plastic and Reconstructive Surgery in the Battlefield.  Invited Guest Lecture, St Georges Medical School Trauma Soc May 11

63. Invited Speaker – Regional Training day for ODPs  -East Grinstead May 11 – Military Plastic Surgery and Reconstruction.

64. Afghanistan and the plastic surgeon.  Invited Guest Speaker – Royal Society of Medicine May 11

65. Military Plastic Surgery – Past and Present. Invited Speaker – East Grinstead Armed Forces Day. June 2011

66. Plastic Surgery and War – Medical Ethics. Invited Presentation to Eton College Sixth Form Nov 2011

67. Reconstruction after Joint Infection. Invited Speaker – Colchester. Jan 2012

68. Afghanistan and the Plastic Surgeon. Invited Speaker – Retired Fellowship, East Grinstead. Mar 2012

69. Reconstruction after Joint Infection. Invited Speaker – London. Mar 2012

70. First Aid for Ballistic Injury. East Grinstead Fire Service. April 2012

CURRENT PROJECTS

International Collaboration

QVH Clinical lead on the MATISS project team – a European funded transfer of knowledge project, working with Academic and Industry partners from many parts of Europe to use Cryogels in Wound care dressings. This involved travelling to Brussels for a meeting and attending other meetings by teleconferencing to provide clinical input into the development process.

Burn Care Projects

1.  The use of sprayed cultured cells in intermediate depth scalds in children

A clinically based research project in East Grinstead and Newcastle. We are carrying out a two centre randomised controlled trial to establish if there is a place for cultured autologous keratinocytes in the management of intermediate depth scalds in toddlers. We have been granted ethical approval , fund raising has achieved the necessary capital, and the first children entered the trial. We started using two groups in East Grinstead; a paraffin gauze only group, and group treated initially with paraffin gauze and cultured cells applied at 2 weeks. Four different groups were recruited in Newcastle, Biobrane alone, Biobrane and cells, Transcyte alone and Transcyte with cells. We hope to demonstrate that a shortened healing time will equate to reduced hypertrophic scar formation. Unfortunately due to technical problems with the cell culture facility and the cessation of distribution of Transcyte we had to pause recruitment. However, we hope to start recruiting again now into a modified protocol.

2.  A specific prevention strategy to tackle the small but significant occurrence of bonfire injury in the young teenagers of Newcastle. We have collected retrospective and prospective data, have run local media campaigns. We have produced a DVD with video footage of burnt children talking about their injuries and with support from the local education authority have shown the  DVD in Newcastle schools. This was followed by a reduction in firework and bonfire injuries in Nov 2006 and 07. The DVDs are now being distributed to a wider area and we hope to achieve National distribution via the Fire-fighters Charity in the future.

3. Laser Doppler imaging during the first 48 hrs after burn injury, a retrospective project comparing actual outcomes with that predicted by the early scans.

4. Considering the time to healing and scar formation patterns in the adult population. To continue the previously published paediatric work.

5. Audit of the actual management of 100 consecutive paediatric burn patients to identify actual healing times and comparing this with Laser Doppler predictions where possible. Aims to confirm the effectiveness of new treatment protocols. Paper in final stages of write up

6. Emergency Management of Severe Burns in the Military setting. Working with the BBA and MOD to try and ensure all military staff treating burn patients on operations have been adequately prepared.

Lower Limb Trauma projects:

1. The appointment of a Nurse practitioner to facilitate the community based management of pretibial lacerations. Aim to reduce delays and hospital length of stays and improve the patient pathway. (Senior Nurse started June 08. Innovations in Acute Care Award Winner for the South East Region, Best of Health Awards. Runner up for the Nationals)

2.  Audit of Lower Limb fracture management at QVH, with reference to the BOA/BAPS guidelines and comparing with previous cohorts.

3. Considering the mental state of Lower Limb trauma patients to identify if an extended treatment course with frequent complications results in psychological morbidity. This will allow us to identify if psychological intervention would be appropriate.

MANAGEMENT SKILLS

Departmental Management – During my training at East Grinstead  I was very involved in the management of the medical staffing for the plastic surgery department. I instituted a hybrid shift system for the SHOs to be compliant with the new deal and worked with the trust management to try to ensure that their training needs were also being met. I was responsible for the weekly rota of  25 plastic surgery medical staff, including SpRs, SHOs, Staff Grades, and Clinical Fellows. I have designed a variety of computerised solutions to assist in this process. In Newcastle I was involved with the running of the Red Team (Burns and Paediatrics) rotas for twelve months. In Chelmsford was heavily involved in the recent PVL/MRSA outbreak attending trust level major incident planning meetings, working with the medical and nursing management and external public health agencies, coordinating all the information and reporting my findings to the group.

Training and Development –Within plastic surgery I have given in house lectures in a large number of topics including Digital Replantation, hand trauma, nasal reconstruction, melanoma care, and many aspects of  burn care . I have formalised my burns instruction interest by becoming an full instructor with the BBA Emergency  Management of Severe Burns Cadre and have lectured on a number of  courses, including the military module. In  2007 I ran a specific Burns Study day for TA personnel about to deploy on operations, giving them practical skills in acute burn management and evacuation considerations, and am working with the BBA to provide a military representative on the EMSB senate.  I have lectured on the Burns and Trauma Course for local Accident and Emergency Staff and  have been an  invited speaker on the pre-hospital management of burns to the local BASICs group and have been invited to speak to the Paediatric surgery registrars on modern burn care. I have also lectured to paediatric intensive care registrars, operating theatre practitioner trainees and nursing staff as part of formal external training programmes, and run a number of informal (but well attended) sessions on burn care to medical and nursing staff. In Dec 03 I examined a basic surgical skills station at the end of stage exams for Medical Students. After being awarded the McGregor Medal for the FRCS (plast) exam in Sept 2006 I was invited to join the instructors team for the East Grinstead FRCS (plast) course in Nov 2007 and have provided a large number of informal teaching sessions for other FRCS (plast) candidates. I have also run a session on Extended Matching Questions for a Pan Thames training day. In the clinical setting I have provided informal teaching to junior medical staff and nursing staff and medical students including practical skills demonstrations, and assessments.

In May 08 I delivered an invited lecture to the South Thames Orthopaedic meeting, discussing how Orthopaedic and Plastic surgeons should work together, with special reference to the management of lower limb trauma.

I plan to formalise my training interest by attending the training the trainers course at the Royal College of  Surgeons.

Information Technology Systems Development – I believe that  information technology should be used to aid in patient management and data collection, I have designed many databases in Microsoft Access that are very easy to use, and have trained both medical and administrative staff to use them. Including a database for infection control mapping, for an outbreak of PVL toxin producing MRSA, and more recently a database for the management of the outreach patients.

Clinical Audit - I have taken part in regular audit meetings, and been involved in many audit projects such as Long Term Paediatric Burn Outcome, Burns weight assessment, Basal Cell Carcinoma management, Scald healing, See and Do Clinics and leg trauma. I have also been responsible for the review of cases for morbidity and mortality discussion. A major audit project was to collect data on all paediatric scalds since 1997 in Newcastle to allow comparison with the East Grinstead cohort, This has now been presented both Nationally and Internationally, and has added to the evidence needed for the ongoing clinical trial into paediatric scald healing. The previously published transfer proforma that we designed in 1998, has  now been adjusted to become the template for the South East Burn Network. We now undertaking another extensive review of the management of pretibial lacerations in the QVH catchment area to confirm the impact of the  nurse practitioners.

Resource Management – In 2007, 08, 09 and 10, I arranged the Combined Services Plastic Surgery meetings. This involved inviting international and national speakers, contacting potential sponsors and delegates. Identifying and organising venue, accommodation, catering, regimental band etc, collecting the sponsorship monies (over £6,000) and paying the bills. Co-ordinating the programme, applying for CPD points, collating the abstracts and CVs and arranging the printing of the abstract books. This was a huge logistic task, which is now undertaken by a team which has successfully run the 2011 and 2012 meetings and is working towards 2013.

Personnel Management –During my previous appointments to East Grinstead I was very involved with the level of staffing of the department. I was especially involved with the concerns about the quality of training for SHOs and have had regular meetings with the management to arrange locum cover and to try and improving long term staffing levels. I am now supervising/mentoring Junior Staff at QVH taking part in the iscp process, encourage their research and audit projects  as well as providing informal exam coaching and advice.

MEMBERSHIPS OF SOCIETIES

FULL MEMBER OF THE BRITISH ASSOCIATION OF PLASTIC SURGEONS

BRITISH MEDICAL ASSOCIATION          

BRITISH BURN ASSOCIATION (also member of the Prevention Committee)

INTERNATIONAL SOCIETY FOR BURN INJURIES 

MILITARY SURGICAL SOCIETY

TRAUMA CARE SOCIETY

OTHER INTERESTS

Family - My daughter Natasha was born in April 98 and my son Christopher in June 2000. They are now both  full boarding and doing well, although Natasha struggles with her dyslexia. My husband tried 6 months as a househusband when the children were small, but re-commissioned into the army for a rest! He is now a Lt Col Medical Support Officer  currently the Commanding Officer of the Defence Medical Establishment, in Lichfield.

Information Technology- I was a director of HC Management Consultants Ltd, a business that supplied tailor made database solutions, especially within the medical field. I am generally computer literate in most aspects of Microsoft office including Word, Excel and PowerPoint although Access is my special interest, and I am happy using the Internet both professionally and to do the routine shopping.

Sport – Awarded Divisional Athletics Colours in 1995 after breaking the Army Medical Services record for Ladies High Jump. My current sporting activity is limited to parents v children rounders matches!  I have participated in charity fun runs and walks over the last few years.

Music- I was a member of a local choir in Northumberland and performed a small solo when we sang in the SAGE in Gateshead November 05, and with 2 other burns surgeons provided the entertainment for a local hotel’s ‘Burns Supper’! I also play guitar, flute and piano for fun. I was previously a member of Cranbrook Town Band playing the E flat Bass (tuba), having achieved Grade IV Trumpet, Grade V theory and Grade VI on Euphonium. I am delighted that both children and interested musicians and Chrisopher at age 12  has already  passed  Grade 4 on the Euphonium!

Driving - Holder of a Class II Heavy Goods Vehicle Licence since 1987, I have very much enjoyed the opportunities of the military to drive a variety of vehicles from land rovers, to enormous recovery vehicles and tanks. Although I achieved solo status in a powered glider, and have a number of hours front seat flying experience I have not recently been able to pursue this interest.

Most prized possessions - a 1971 Morris Minor Traveller (now a little bent) and a rather expensive two story Wendyhouse.

REFEREES

Plastic Surgery

Mr P Dziewulski FRCS (Plast)

Director of St Andrews Burn Centre

Broomfield Hospital

Chelmsford

CM1 7ET

Mrs S A Pape FRCSEd (Plast)

Director of the Northern Regional Burn Network

Royal Victoria Infirmary

Newcastle Upon Tyne

NE1 4LP

Mr  Roger Smith FRCS

Consultant Plastic Surgeon and Director of Research and Development

Queen Victoria Hospital

East Grinstead

RH19 3DZ

Mr P Gilbert FRCS (Ed) (Plast)

Lead Clinician and Director of McIndoe Burns Unit

Queen Victoria Hospital

East Grinstead

RH19 3DZ

Military Aspects of Plastic Surgery

Col Alan Kay

Defence Consultant Advisor in Plastic Surgery

Royal Centre for Defence Medicine

QE II Hospital

Birmingham