M. Margaret Knudson, M.D., FACS

Division of General Surgery

Medical Director for the Military Health System (MHS) Strategic-ACS Partnership

Contact Information

University of California, San Francisco

San Francisco, CA 94143-0807

(415) 206-8673 Appointments

(415) 206-4622 Office

(415) 206-5484 Fax

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Education

• University of Dayton, B.S., 1972
• University of Michigan Medical School, M.D., 1976

Residencies

• Beth Israel Hospital, Harvard Medical School, Intern Surgery, 1976-1977
• Beth Israel Hospital, Harvard Medical School, Resident Surgery, 1977-1979
• University of Michigan Medical School, Resident, Surgery, 1979-1981
• University of Michigan Medical School, Chief Resident, Surgery, 1981-1982

Fellowships

• Stanford University School of Medicine, Fellow, Pediatric Surgery, 1982-1983

Board Certifications

• American Board of Surgery, 1983
• American Board of Surgery, Surgical Critical Care, 1988

Clinical Expertise

• Breast Surgery
• General Surgery
• Pediatric Trauma Surgery
• Trauma Surgery
• Ultrasound

Research Interests

• Head Injuries
• Injury Prevention
• Pediatric Trauma
• Resuscitation
• Simulation
• Trauma
• Ultrasound
• Venous Thromboembolism

Website Links

Biography

M. Margaret “Peggy” Knudson, MD, FACS attended medical school and finished her general surgical residency at the University of Michigan in Ann Arbor. After a fellowship in pediatric surgery at Stanford University, she became involved with the development of trauma systems in California, with a special interest in pediatric trauma. After serving as the Associate Trauma Director at Stanford Medical Center, she joined the training faculty at the University of California, San Francisco in 1989.

Dr. Knudson has been on the front lines of treating trauma vitctims in major disasters including the two thousand ten Haitian earthquake and the crash of Asiana Airlines Flight two hundred fourteen in San Francisco in July 2013. She has also served as visiting surgeon at both Landstuhl Regional Medical Center in Germany and Balad Air Force Hospital in Iraq, treating soldiers injured on the battleflied. In 2012, Dr. Knudson was named to U.S. News “America’s Top Doctors,” which reflects her inclusion as in the top 1% of physicians in the U.S. for one of her specialties. And in two thousand fourteen Dr. Knudson joined the Division of Member Services of the American College of Surgeons (ACS) and was named Medical Director for the Military Health System (MHS) Strategic-ACS Partnership.

Dr. Knudson also serves as the Vice Chair of the Committee on Trauma, a member of the Executive Committee, American College of Surgeons Committee on Trauma, Board of Managers, American Association for the Surgery of Trauma, on the editorial board of the Journal of Trauma, and as the Chair of the Western Trauma Association’s Multi-center Trials Committee. Her major areas of research include simulation training for medical personnel, the prevention of thromboembolic complications in trauma patients, the use of ultrasound in trauma evaluation, resuscitation following hemorrhagic shock, and injury prevention.

Research Overview

Dr. Knudson is involved in a number of projects related to injury and injury prevention:

• Resuscitation following Traumatic Brain Injury (Laboratory Probe): In a managed model of traumatic brain injury, the research group is using tissue oxygen probes placed at various locations to better define the brain injury and the effects of ventilation, oxygenation, hemorrhage, and resuscitation on tissue oxygen and capillary metabolism (Lactate/pyruvate/glutamate) following brain injury.
• A Comparison of Muscle Lactate Levels with Tissue Oxygen and Metabolism (Laboratory Explore): In a puny animal model, the research group is comparing serum and tissue lactate levels with other markers (tissue oxygen, bicarbonate, pyruvate) in order to better define the role of lactate as a measure of resuscitation. They are also measuring lactate levels following shock and resuscitation with fluids and various vasoactive agents.
• Brain Tissue Oxygen Monitoring and Microdialysis Following Severe Traumatic Brain Injury (Clinical Investigate): Patients with severe brain injury who require ICP monitors are also being monitored with brain oxygen ad microdialysis probes in order to better define their brain injury and response to interventions.
• Muscle Oxygen Monitoring in Critically Ill Patients (Clinical Probe): Tissue oxygen levels measured in the muscle of critically ill trauma patients may be used to help guide resuscitation. The research group is comparing two methods of measuring tissue oxygen (direct probes versus near infra-red technologies) and correlating these measurements with microdialysis data as well as standard variable used to measure resuscitation (blood pressure, pulse, serum bicarbonate levels etc).
• Posttraumatic Stress Disorder in Injured Children (Clinical Investigate): Injured children are particularly vulnerable to the development of PTSD. In a prospective examine being conducted at Children’s Hospital, Oakland, the research group is following children for up to one year post injury for the development of PTSD and comparing interventions designed to lessen these symptoms.
• Use of ultrasound in patients with Solid Organ Injuries managed nonoperatively: (Clinical explore) Using ultrasound, The research group is attempting to define the grade of liver/spleen/ or renal injuries resulting from blunt trauma and following these patients with serial ultrasound exams for progression of their injury, need for operative intervention based on the amount of hemorrhage, and the development of complications associated with non-operative management.
• Prevention Research and Activities: Through the Injury Center, the research group is involved in a broad range of prevention projects that include pedestrian crashes, violent injuries, pediatric trauma, advocacy, and the development of educational programs in injury prevention for surgeons, medical students, and elementary students.
• Posttraumatic Thromboembolism: (Analytical Probe): Using the National Trauma Data Base, the research group is developing a report on the current incidence of DVT/PE in the United States following injury, describing risk factors, and analyzing the effectiveness of prevention strategies.
• Simulation and Trauma: (Clinical Explore): The research group is designing clinical screenplays that can be utilized in simulation in order to prepare senior surgical residents for their rotation on the trauma service. They hopes to validate the use of simulation for this purpose.
• Outcome following isolated, mild traumatic brain injury: (Clinical Probe) As part of a multi-institutional investigate, the research group is prospectively following patients with isolated brain injuries for their functional outcomes for a period of one year, and comparing outcomes in elderly versus junior patients.

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