• Skarsgard, Erik D.

    Titles

    Investigator, BC Children's Hospital
    Surgeon in Chief, Department of Pediatric Surgery, BC Children’s Hospital
    Professor, Division of Pediatric General Surgery, Department of Surgery, University of British Columbia

    Degrees / Designations
    M.Sc., MD
    Primary Area of Research
    Evidence to Innovation
    Secondary Area(s) of Research
    Phone
    604-875-3744
    Fax
    604-875-2721
    Lab Phone
    Assistant
    Maria Lopes Chau
    Assistant Phone
    604-875-2548
    Mailing Address

    BC Children's Hospital
    Room K0-110 ACB
    4480 Oak Street
    Vancouver, BC V6H 3V4

    Affiliate Websites
    Research Areas
    • Birth defects 
    • Neonatal surgical outcomes 
    • Perinatal networks 
    • Prenatal Diagnosis and Intrauterine surgery 
    Summary

    A major focus of my research is the short and long term functional outcomes following neonatal treatment of structural birth defects. Study of these rare and complex birth defects has been facilitated by the Canadian Pediatric Surgery Network (CAPSNET) and Data Registry. Founded in 2006 with CIHR operating grant support, and maintained continuously since with CIHR funding, CAPSNet has enabed the publication of >40 peer reviewed manuscripts. Recent knowledge translation efforts of the Network have focused on practice standardization for gastroschisis and congenital diaphragmatic hernia using available best practice evidence. CAPSNet’s Annual Report provides benchmarked, risk-adjusted outcomes data for each of its 17 participant centres, which are used to guide site-based targeted practice improvement.   

    The recently completed Secondary Analysis of Databases project combined CAPSNet data with vital statistics data (Stats Canada) to make first time observations of the epidemiology of gastroschisis in Canada, including maternal, environmental and sociodemographic risk factors. Using spatial mapping techniques, we have made observations of significant geographic variation in the incidence of gastroschisis, which points to other possible mechanisms of environmental causation requiring further study.

    Surgical Quality and Safety:

    One of our greatest opportunities for surgical outcome improvement lies in the use of high quality patient level data to recognize and enable surgical outcome variation as a driver of continuous quality improvement. BC Children’s Hospital is currently the only Canadian Children’s Hospital participant in the American College of Surgeons (ACS) pediatric National Surgical Quality Improvement Program (NSQIP). By collecting case data on selected surgical procedures, and through analysis of our risk-adjusted “performance” against the other 50 odd US children’s hospitals, we gain an awareness of where we have the greatest opportunities for outcome improvement. Using published evidence, and by analyzing our own risk predictors for occurrences, we can use the tools of implementation science to modify our processes and continually improve our surgical outcomes.    

    Current Projects

    Surgical Telehealth program: With the support of Child Health BC, we have established surgical telehealth sites in each of the health authorities. We are in the process of studying the scope of surgical ambulatory practice that is amenable to telehealth technology, and assessing the value of telehealth from both the patient/family and provider perspectives.

    Selected Publications

    Al-Kaff A, MacDonald SC, Kent N, Burrows J, Skarsgard ED, Hutcheon JA; Canadian Pediatric Surgery Network.  Delivery planning for pregnancies with gastroschisis: findings from a prospective national registry.  Am J Obstet Gynecol (in press).

    Woo RK, Skarsgard ED.  Innovating for quality and value: Utilizing national quality improvement programs to identify opportunities for responsible surgical innovation.  Semin Pediatr Surg. 2015 Jun;24(3):138-40. PMID: 25976151

    Beaumier CK, Beres AL, Puligandla PS, Skarsgard ED; Canadian Pediatric Surgery Network.  Clinical characteristics and outcomes of patients with right congenital diaphragmatic hernia: A population-based study. J Pediatr Surg 2015 May;50(5):731-3. PMID: 25783377

    Skarsgard ED, Meaney C, Bassil K, Brindle M, Arbour L, Moineddin R; Canadian Pediatric Surgery Network (CAPSNet).  Maternal Risk Factors for Gastroschisis in Canada.  Birth Defects Res A Clin Mol Teratol 2015 Feb;103(2):111-8. PMID: 25684659

    Emami CN, Youssef F, Baird RJ, Laberge JM, Skarsgard ED, Puligandla PS; Canadian Pediatric Surgery Network (CAPSNet).  A risk-stratified comparison of fascial versus flap closure techniques on the early outcomes of infants with gastroschisis.  J Pediatr Surg 2015 Jan;50(1):102-6. PMID: 25598103

    Stanger J, Mohajerani N, Skarsgard ED, Canadian Pediatric Surgery Network (CAPSNet).  Practice Variation in Gastroschisis: Factors Influencing Closure Technique.  J Pediatr Surg 2014 May;49(5):720-3. PMID: 24851755

    Skarsgard ED, Bedford J, Chan T, Whyte S, Afshar K.  ACS National Surgical Quality Improvement Program: Targeting Quality Improvement in Canadian Pediatric Surgery.  J Pediatr Surg 2014 May;49(5):682-7. PMID: 24851748

    Segal I, Kang C, Albersheim SG, Skarsgard ED, Lavoie, PM.  Surgical site infections in infants admitted to the neonatal intensive care unit.  J Pediatr Surg 2014 Mar;49(3):381-4. PMID: 24650461

    Arneja J, Goto J, Blair G, Gold L, Fitzsimmons B, Masterson J, Skarsgard E.  What's the Best Way to Allocate or Block Time? A Data Driven Approach to Departmental "Operations."  Plast Reconstr Surg 2014 Mar;133(3 Suppl):10. doi: 10.1097/01. PMID: 25942112

    Alshehri A, Emil S, Laberge JM, Skarsgard ED, Canadian Pediatric Surgery Network.  Outcomes of early versus late intestinal operations in patients with Gastroschisis and Intestinal Atresia:  Results from a national database.  J Pediatr Surg  2013 Oct;48(10):2022-6. PMID: 24094951

    Langer M, Safavi A, Skarsgard ED.  Management of the base of the Appendix in Pediatric Laparoscopic Appendectomy:  Clip, ligate or staple?  Surg Technol Int 2013 Sep; 23:81-3. PMID: 23975448

    Goodwin WM, Beres A , Baird R, Laberge J-M, Skarsgard ED, Puligandla PS, Canadian Pediatric Surgery Network (CAPSNet).  Congenital diaphragmatic hernia (CDH) mortality without surgical repair? A plea to clarify surgical ineligibility.  J Pediatr Surg 2013 May;48(5):924-9. PMID: 23701761

    Aljahdali A, Mohajerani N, Skarsgard ED; Canadian Pediatric Surgery Network (CAPSNet).  Effect of timing of enteral feeding on outcome in gastroschisis.  J Pediatr Surg 2013 May;48(5):971-6. PMID: 23701769

    Zerhouni S, Mayer C, Skarsgard ED.  Can we select fetuses with intra-abdominal calcification for delivery in neonatal surgical centres?  J Pediatr Surg 2013 May;48(5):946-50. PMID: 23701765

    DeGirolamo K, Courtemanche DJ, Hill WD, Skarsgard ED.  Use of safety scalpels and other safety practices to reduce sharps injury in the operating room:  What is the Evidence?  Can J Surg 2013 Aug;56(4):263-9. PMID: 23883497

    Safavi A, Lai S, Butterworth S, Hameed M, Schiller D, Skarsgard E. Does Operative Experience during Residency Correlate with Reported Competency of Recent General Surgery Graduates?  Can J Surg 2012;55(4):S171-7. PMID: 22854144

    Cowan KN, Puligandla PS, Laberge JM, Skarsgard ED, Bouchard S, Yanchar N, Kim P, Lee S, McMillan D, von Dadelszen P; The Canadian Pediatric Surgery Network.The gastroschisis prognostic score: reliable outcome prediction in gastroschisis. J Pediatr Surg 2012 Jun;47(6):1111-7. PMID: 22703779

    Akhtar J, Skarsgard ED; Canadian Pediatric Surgery Network (CAPSNet). Associated malformations and the "hidden mortality" of gastroschisis.  J Pediatr Surg 2012 May;47(5):911-6. PMID: 2259557

    Mills J, Safavi A, Skarsgard ED; Canadian Pediatric Surgery Network (CAPSNet). Chylothorax after congenital diaphragmatic hernia repair: a population-based study.  J Pediatr Surg 2012 May;47(5):842-6. PMID: 22595558

    Safavi A, Synnes AR, O'Brien K, Chiang M, Skarsgard ED, Chiu PP; Canadian Pediatric Surgery Network. Multi-institutional follow-up of patients with congenital diaphragmatic hernia reveals severe disability and variations in practice. J Pediatr Surg 2012 May;47(5):836-41. PMID: 22595557

    Sangha BS, Skarsgard ED, Heran MK. Transscapular Microcoil Lung Nodule Localization. J Vasc Interv Radiol 2012 May;23(5):659. PMID: 22341634

    Safavi A, Skarsgard E, Butterworth S, Canadian Pediatric Surgery Network.  Bowel-defect disproportion in gastroschisis: does the need to extend the fascial defect predict outcome?  Pediatr Surg Int 2012 May;28(5):495-500. PMID: 22331201

    Yong PJ, Von Dadelszen P, Carpara D, Lim K, Kent N, Tessier F, Delisle MF, Wong T, Blair G, Skarsgard ED. Prediction of Pediatric Outcome after Prenatal Diagnosis and Expectant Antenatal Management of Congenital Cystic Adenomatoid Malformation. Fetal Diagn Ther 2012;31(2):94-102. PMID: 22310905

    Safavi A, Langer M, Skarsgard ED. Endoloop versus endostapler closure of the appendiceal stump in pediatric laparoscopic appendectomy. Can J Surg 2012 Feb;55(1):37-40. PMID: 22269300

    Baird R, Puligandla P, Skarsgard E, Laberge JM; The Canadian Pediatric Surgery Network. Infectious complications in the management of gastroschisis.  Pediatr Surg Int 2012 Apr;28(4):399-404. PMID: 22159577

    Jansen LA, Safavi A, Lin Y, Macnab YC, Skarsgard ED; the Canadian Pediatric Surgery Network (CAPSNet). Preclosure Fluid Resuscitation Influences Outcome in Gastroschisis. Am J Perinatol 2012 Apr;29(4):307-12. PMID: 22094919

    Heran MK, Sangha BS, Mayo JR, Blair G, Skarsgard ED. Lung nodules in children: video-assisted thoracoscopic surgical resection after computed tomography-guided localization using a microcoil. J Pediatr Surg 2011 Jun; 46(6):1292-7. PMID: 21683242

    Baird R, Eeson G, Safavi A, Puligandla P, Laberge J-M, Skarsgard ED, Canadian Pediatric Surgery Network.  Institutional Practice and Outcome Variation in the Management Of Congenital Diaphragmatic Hernia and Gastroschisis in Canada:  A report from the Canadian Pediatric Surgery Network (CAPSNet).  J Pediatr Surg;46(5):801-7, 2011. PMID: 21616230

    Levine DS, Metzger DL, Nadel HR, Oviedo A, Adam MJ, Skarsgard E. Novel use of F-DOPA PET/CT imaging in a child with paraganglioma/pheochromocytoma syndrome. Pediatr Radiol 2011 Oct;41(10):1321-5. PMID: 21567141

    Brindle ME, Brar M, Skarsgard ED, Canadian Pediatric Surgery Network. Patch Repair is an Independent Predictor of Morbidity and Mortality in Congenital Diaphragmatic Hernia (CDH). Pediatr Surg Int 2011 Sep;27(9):969-74. PMID: 21590477

    Boutros J, Bond M, Beaudry P, Blair GK, Skarsgard ED.: Case selection in minimally invasive surgical treatment of neuroblastoma. Pediatr Surg Int. 2008 Oct;24(10):1177-80. PMID: 18716783

    Lam MC, Yang PT, Skippen PW, Kissoon N, Skarsgard ED.: Abdominal compartment syndrome complicating paediatric extracorporeal life support: diagnostic and therapeutic challenges. Anaesth Intensive Care. 2008 Sep;36(5):726-31. PMID: 18853595

    Heran MK, Baird R, Blair GK, Skarsgard ED.: Topical mitomycin-C for recalcitrant esophageal strictures: a novel endoscopic/fluoroscopic technique for safe endoluminal delivery. J Pediatr Surg. 2008 May;43(5):815-8. PMID: 18485945

    Lam MW, Klassen AF, Montgomery CJ, LeBlanc JG, Skarsgard ED.: Quality-of-life outcomes after surgical correction of pectus excavatum: a comparison of the Ravitch and Nuss procedures. J Pediatr Surg. 2008 May;43(5):819-25. PMID: 18485946

    Baird R, MacNab YC, Skarsgard ED; Canadian Pediatric Surgery Network.: Mortality prediction in congenital diaphragmatic hernia. J Pediatr Surg. 2008 May;43(5):783-7. PMID: 18485938

    Weinsheimer RL, Yanchar NL, Bouchard SB, Kim PK, Laberge JM, Skarsgard ED, Lee SK, McMillan D, von Dadelszen P; Canadian Pediatric Surgery Network.: Gastroschisis closure--does method really matter?. J Pediatr Surg. 2008 May;43(5):874-8. PMID: 18485957

    Klassen AF, Stotland MA, Skarsgard ED, Pusic AL.: Clinical research in pediatric plastic surgery and systematic review of quality-of-life questionnaires. Clin Plast Surg. 2008 Apr;35(2):251-67. PMID: 18298997

    Skarsgard ED, Claydon J, Bouchard S, Kim PCW, Laberge JM, McMillan D , von Dadelszen P, Yanchar N and the Canadian Pediatric Surgical Network.  CAPSNET: A Population-based Pediatric Surgery Network and Database for analyzing Surgical Birth defects.  The first 100 cases of Gastroschisis. J Pediatr Surg 43:  30-4; 2008. PMID: 18206451

    Butterworth SA, Blair GK, LeBlanc JG, Skarsgard ED.  An Open and Shut Case for Early VATS Treatment of Primary Spontaneous Pneumothorax in Children. Can J Surg 50:171-4; 2007. PMID: 17568487

    Amari E, VandeBeek C, Warnock F, Skarsgard ED, Ansermino M.  Measuring the Quality of Pediatric Day Surgery Care.  Journal for Healthcare Quality 29:  36-44; 2007. PMID: 18232606

    Nahum E, Skippen PW, Gagnon RE, Macnab AJ, Skarsgard ED.  Correlation of transcutaneous hepatic near-infrared spectroscopy readings with liver surface readings and perfusion parameters in a piglet endotoxemic shock model. Liver Int 26:1277-82;2006. PMID: 17105594

    Lam JC, Claydon J, Mitton CR, Skarsgard ED.  A Risk-Adjusted Study of Outcome and Resource Utilization for Congenital Diaphragmatic Hernia. J Pediatr Surg 41:883-7;2006. PMID: 16677875

    Skarsgard ED, Huang L, Reebye SC, Yeung AY, Jia WW.  Lentiviral-vector mediated, in vivo Gene Transfer to the Tracheobronchial Tree in Fetal Rabbits. J Pediatr Surg 40:1817-21;2005. PMID: 16338297

    Skarsgard ED, MacNab YC, Qiu Z, et al.  SNAP-II predicts mortality among infants with congenital diaphragmatic hernia. J Perinatol 25:315-9;2005. PMID: 15716986
     
    Skarsgard ED, Salt D, Lee SK. Venovenous extracorporeal membrane oxygenation (ECMO) in neonatal respiratory failure: does routine cephalic jugular drainage improve outcome? J Pediatr Surg 39:672-6;2004. PMID: 15136997

    Grants
    Honours & Awards

    UBC Faculty of Medicine Distinguished Achievement Award for Overall Excellence,  April 1, 2007-Mar 31, 2008. 

    Richard J. Finley Senior Research Scholar Award.  UBC Dept of Surgery, June 2008

    James IV Association of Surgeons Traveling Fellowship, 2008

    AD Forward Postgraduate Faculty Teaching Award, Department of  Surgery, University of British Columbia, 2007

    University of British Columbia Department of Pediatrics, Teacher of the Year, 2006

    Hjalmar K. Johnson New Investigator Award, Department of Surgery, University of British Columbia, 2005

    Edwin F. Ross Visiting Lecturer, Dalhousie University Department of Surgery, Halifax , NS, May 2005

    H. Rocke Robertson Undergraduate Faculty Teaching Award, Department of Surgery, University of British Columbia, 2004

    Best Doctors in San Francisco , San Francisco Magazine, January 2001
    Duncan Gordon Scholar, The Hospital For Sick Children Foundation, Toronto, 1993-94

    Research Group Members
    • Patrick Yang, MD/PhD Candidate, UBC
    • William Jia, PhD, Brain Centre UBC 
    • Anthony Cheung, PhD EnGene (Scientific Director) 
    • Louis Huang, Former MSc Student (Engene) 
    • Jessica Mills, General Surgery Resident, UBC 
    • Lien Hoang, UBC Med Class of 2010, 2007 CFRI Summer Research Student 
    • Mindy Lam, UofA Med Class of 2009, 2007 CFRI Summer Research Student 
    • Jennifer Claydon – CAPSNET Coordinator 
    • Adrian Bartel – CAPSNET Data Manager