Dr. Jana Dengler


Affiliations: Hand and Nerve Surgeon, Division of Plastic Surgery, Sunnybrook Health Sciences Centre

Research Interests:

My overarching research interests are to improve access to care, processes of care and outcomes in peripheral nerve injuries and cervical-level spinal cord injury. The field of nerve surgery has evolved rapidly over the past two decades, and the number and complexity of surgical options to treat nerve injuries continues to grow. Because of axon and muscle degeneration following nerve injury, intervention is time-sensitive, and it is imperative that patients be assessed in a timely fashion. Nerve transfer surgery also offers an exciting opportunity to increase independence and quality of life in cervical-level spinal cord injury patients, but upper extremity surgery remains severely under-utilized in this vulnerable patient population. It is my goal to, first, develop a better understanding of the barriers to accessing these novel procedures in the peripheral nerve and spinal cord injury patient populations; second, to develop strategies to address these barriers (whether this be through patient education, provider education, improving referral patterns, developing practice guidelines or other interventions); and third, to assess the success of those strategies.

Brief Bio:

After obtaining my undergraduate and graduate degrees in chemical and biomedical engineering, I completed medical school and residency training in Plastic and Reconstructive Surgery at the University of Toronto. I then went on to complete a fellowship in Hand, Peripheral Nerve and Microsurgery at Washington University in St. Louis, MO. I am now returning to Toronto to start my academic career in the Division of Plastic Surgery at Sunnybrook Health Sciences Centre where my clinical focus will be on peripheral nerve surgery and upper extremity reconstruction, including the surgical management of patients with iatrogenic and traumatic nerve injury, brachial plexus injury and cervical-level spinal cord injuries.

Capstone Project:

Cervical spinal cord injury (SCI) is a devastating event that results in upper limb paralysis, loss of independence, and disability. At an estimated lifetime cost of $3 million, cervical SCI places a substantial economic burden on the individual and the healthcare system. People living with cervical SCI have identified improvement of upper limb function as a top priority. Nerve and tendon transfer surgery has successfully restored upper limb function in cervical SCI, but is not universally used or available to all eligible individuals. The barriers preventing utilization of upper limb reconstruction are a complex interrelation of individual, healthcare provider and system level factors. Our exploratory qualitative study will use an implementation science approach to better understand these factors that influence access to upper limb reconstruction in the Canadian context and design an intervention to increase access to care.

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