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Advancing the Science of Burn Care

Marc Jeschke
Marc Jeschke consults
with a remote burn
patient via the wonders
of telemedicine

Hypertrophic scarring in burn patients is a problem that is treated with pressure garments worn for as long as two years. They are measured and refitted every three to four months. Massage is also used up six or seven times a day by physiotherapists. Marc Jeschke uses stem cells from abdominal fat obtained by liposuction to reduce scarring. He also uses silicone sheets, lasers, cortisone injections and topical cortisone applications, as well as 5 FU to reduce scarring. He showed me pictures of a patient severely deformed by keloid formation over the face who was treated by radical excision, advancement of skin flaps and injection of stem cells into the wound. The stem cells follow epigenetic factors in the surrounding tissues to differentiate into the appropriate cell line. The cosmetic result was excellent.

In 1994, Marc Jeschke completed medical school and his thesis summa cum laude in Tubingen, Germany. He completed a research Fellowship from 1996- 1999 with the University Texas Medical Branch and Shriners Hospital for Children. During this time he completed his Masters of Medical Science. He returned to Germany, to the Department of Surgery at the University of Regensburg where received his surgical training and was awarded the habilitation (PhD) in Experimental Surgery in 2001. He returned to the University Texas Medical Branch and Shriners Hospital for Children in 2004 as Attending Surgeon and Coordinator of Research.

Furthering his interest in burn and critical care, Marc undertook a clinical fellowship rom August 2005 to June 2006 as the Burn and Critical Care Fellow at the University Texas Medical Branch and Shriners Hospital for Children, the only program to be certified by ACMG.

In May 2010, Marc was appointed Director of the Ross Tilley Burn Centre at Sunnybrook Health Science Centre and Surgeon -Scientist in the Division of Plastic and Reconstructive Surgery.

Marc has been caring for burn patients and conducting research in the field of burns for nearly 20 years and in that time has published more than 180 peer-reviewed articles and has authored several books and chapters on burn care. He was continuously funded as the Principal Investigator since 2000 from the German Research Council, the National Institutes of Health, and Shriners Hospital for Children Foundation.

He has mentored and trained more than 40 PhD, MD, and other graduate students in the field of burn care and burn-related research.

The Ross Tilley Burn Centre has its own operating room and strong support from Sunnybrook Health Sciences Centre, but the novel legislative requirement that every burn in the province can be admitted to a burn centre results in a lot of patients needing primary burn operations. "It is hard to do reconstructive or other cases when you are treating so many burns." Marc and his team collect tissue for research from every operation under REB approval.


The Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery at the Sunnybrook Health Sciences Centre has been certified as an adult burn centre after a site visit in June 2011. Toronto now becomes the sole designated certified burn centre sanctioned by the American Board of Surgery in all of Canada. Special thanks to Marc Jeschke and his team for this accomplishment.

Marc has three main research foci. One is to create skinfrom umbilical cord and amniotic membrane cells. The research team includes laboratory staff and an engineer. "The most difficult part of this quest is getting the matrix for the cells. Integra, a commercial matrix material based on John Burke’s work in Boston is a silicone bandage on bovine collagen. Integra is an excellent bioengineered device that helps burn surgeons treat delicate areas, but it is extremely expensive. At RTBC we use it for the face and hands, but we cannot justify the expense to use it on extensive body burns. The silicone is peeled off after the Integra bandage has been applied for 2-3 weeks and a thin autograft is applied to the Integra base."

The second research theme examines the effect of stress on the endoplasmic reticulum and mitochondria using a human liver model. A paper on this work is in press in the Annals of Surgery. The third theme is treatment of insulin resistance. It is unclear whether it is glucose or other factors such as catecholamines induced by glucose that cause resistance. Marc is studying the use of insulin and metformin effects on tissues and on infection with his colleagues Alison Cheung, PhD clinical research manager, and Rachael Harrison, PhD, lab manager. He has not yet had surgeon-scientists in the program, but has two current fellows, one from Spain and one from Bahrain, and several PhD and Masters" Degree students.


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