M. Margaret Knudson, M.D., FACS
Professor of Surgery,
Division of General Surgery
Medical Director for the Military Health System (MHS) Strategic-ACS Partnership
Contact Information
Campus Box 0807
University of California, San Francisco
San Francisco, CA 94143-0807
(415) 206-8673 Appointments
(415) 206-4622 Office
(415) 206-5484 Fax
Peggy.Knudson@ucsf.edu
University of California, San Francisco
San Francisco, CA 94143-0807
(415) 206-8673 Appointments
(415) 206-4622 Office
(415) 206-5484 Fax
Peggy.Knudson@ucsf.edu
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 completed 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 teaching 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 2010 Haitian earthquake and the crash of Asiana Airlines Flight 214 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 2014 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 Study): In a controlled 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 Study): In a small 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 Study): 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 Study): 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 techniques) 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 Study): Injured children are particularly vulnerable to the development of PTSD. In a prospective study 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 study) 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 wide 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 Study): 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 Study): The research group is designing clinical scenarios 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 Study) As part of a multi-institutional study, 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 younger patients.
Publications
Most recent publications from a total of 84
- , Elster EA, Bailey JA, Johannigman JA, Bailey PV, Schwab CW, Kirk GG, Woodson JA. Military-Civilian Partnerships in Training, Sustaining, Recruitment, Retention, and Readiness: Proceedings from an Exploratory First-Steps Meeting. J Am Coll Surg. 2018 Aug; 227(2):284-292. View in PubMed
- Loja MN, , DuBose J, Li CS, Liu Y, Savage S, Scalea T, Holcomb JB, Rasmussen TE, . The mangled extremity score and amputation: Time for a revision. J Trauma Acute Care Surg. 2017 03; 82(3):518-523. View in PubMed
- Price MA, Beilman GJ, Fabian TC, Hoyt DB, Jurkovich GJ, , MacKenzie EJ, Marshall VS, Overton KE, Peitzman AB, Phillips MJ, Pruitt BA, Smith SL, Stewart RM, Jenkins DH. The National Trauma Institute: Lessons learned in the funding and conduct of 16 trauma research studies. J Trauma Acute Care Surg. 2016 09; 81(3):548-54. View in PubMed
- Campion EM, Juillard C, , Dicker R, Cohen MJ, , , . Reconsidering the Resources Needed for Multiple Casualty Events: Lessons Learned From the Crash of Asiana Airlines Flight 214. JAMA Surg. 2016 06 01; 151(6):512-7. View in PubMed
- Shackford SR, Cipolle MD, Badiee J, Mosby DL, , Lewis PR, McDonald VS, Olson EJ, Thompson KA, Van Gent JM, Zander AL. Determining the magnitude of surveillance bias in the assessment of lower extremity deep venous thrombosis: A prospective observational study of two centers. J Trauma Acute Care Surg. 2016 May; 80(5):734-9; discussion 740-1. View in PubMed
- , Elster EE, Woodson J, Kirk G, Turner P, Hoyt DB. A Shared Ethos: The Military Health System Strategic Partnership with the American College of Surgeons. J Am Coll Surg. 2016 06; 222(6):1251-5. View in PubMed
- Hawryluk GW, Phan N, Ferguson AR, Morabito D, Derugin N, Stewart CL, , Manley G, Rosenthal G. Brain tissue oxygen tension and its response to physiological manipulations: influence of distance from injury site in a swine model of traumatic brain injury. J Neurosurg. 2016 11; 125(5):1217-1228. View in PubMed
- , Tarpley MJ, Numann PJ. Global surgery opportunities for U.S. surgical residents: an interim report. J Surg Educ. 2015 Jul-Aug; 72(4):e60-5. View in PubMed
- Privette AR, Evans AE, , Nelson MF, , , , Cohen MJ. Beyond emergency surgery: redefining acute care surgery. J Surg Res. 2015 Jun 01; 196(1):166-71. View in PubMed
- Arbogast H, Burke RV, Muller V, Ruiz P, , , Upperman JS. Randomized controlled trial to evaluate the effectiveness of a video game as a child pedestrian educational tool. J Trauma Acute Care Surg. 2014 May; 76(5):1317-21. View in PubMed
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In the News
- UCSF Department of Surgery at Zuckerberg San Francisco General - - December 04, 2018The National Trauma Institute recently issued an update on the progress of CLOTT Study, a 2nd phase that will more closely investigate the role of platelet biology in post-traumatic pulmonary embolism. To that end, UCSF surgeon-scientist Lucy Kornblith, M.D. has been recruited by principal investigator M. Margaret "Peggy" Knudson, M.D., FACS. Following a productive investigation of the incidence of pulmonary thrombi after injury and the role of clot breakdown in the development of [...]
- UCSF Department of Surgery at Zuckerberg San Francisco General - - August 25, 2018Fostering Military Medical Readiness and Rapid Civilian Mass Casualty/Disaster Response The Military Health System Strategic Partnership with the American College of Surgeons (MHSSPACS) has advanced multiple projects designed to improve military readiness and bolster the performance of permanent civilian trauma institutions. UCSF trauma surgeon M. Margaret "Peggy" Knudson, M.D., FACS is the partnership's medical director. Based at Zuckerberg San Francisco General Hospital (ZSFG), Dr. [...]
- UCSF Department of Surgery at Zuckerberg San Francisco General - - June 15, 2018The CLOTT (Coalition of Leaders in Thromboembolism) study group, led by trauma surgeon M. Margaret "Peggy" Knudson, M.D., FACS, has begun enrolling patients in a landmark clinical trial looking at the treatment and prevention of post-traumatic pulmonary embolism. The study, which includes investigators at 17 Level 1 trauma centers, is funded by a $4.25M grant from the Defense Medical Research and Development Program (DMRDP). Dr. Knudson, the study's principal investigator, is a professor [...]
- UCSF Department of Surgery at Zuckerberg San Francisco General - - December 14, 2017In the wake of October's mass shooting at a Harvest country music festival in Las Vegas, Vox News reached out to UCSF trauma surgeon M. Margaret "Peggy" Knudson, M.D., FACS for her thoughts on how doctors manage an influx of mass shooting victims, and the critical techniques for ensuring their patients' survival. Knudson, a professor in the UCSF Department of Surgery at Zuckerberg San Francisco General (ZSFG), is a nationally recognized expert on mass trauma events and war injuries. Currently [...]
- UCSF Department of Surgery at Zuckerberg San Francisco General - - March 15, 2017M. Margaret "Peggy" Knudson, M.D., FACS was invited last year to give the 42nd American Association for the Surgery of Trauma Fitts Oration. The theme, "When peace breaks out", sounded a clarion call for training civilian and military surgeons alike to handle mass trauma cases arising from domestic terror events, natural or man-made disasters, and casualties of future wars. Dr. Knudson, an academic surgeon, has had a rich and multifacted career in trauma care, including service as a Senior [...]
- UCSF Department of Surgery at Zuckerberg San Francisco General - - March 05, 2017UCSF News reports on this year's Heroes & Hearts Award ceremony at which UCSF trauma surgeon M. Margaret "Peggy" Knudson, M.D., FACS and three other recipients where honored. The Heroes & Hearts program, is celebrated "as a way to bring the community together to celebrate the essential role Zuckerberg San Francisco General Hospital plays in the city and to honor local heroes whose actions improve the community." The award recognizes extraordinary heroes in the San Francisco Bay [...]
- UCSF Department of Surgery at Zuckerberg San Francisco General - - February 10, 2017San Francisco General Hospital Foundation recently announced that UCSF trauma surgeon M. Margaret "Peggy" Knudson, M.D., FACS was among four recipients of the 2017 Heroes & Hearts Award who will be honored at the Foundation's annual Heroes & Hearts luncheon on Thursday, February 16, 2017 at AT&T Park. . The award recognizes extraordinary heroes in the San Francisco Bay Area who exemplify the "go above and beyond" spirit of the Foundation, and Priscilla Chan and Mark Zuckerberg [...]
- UCSF Department of Surgery at Zuckerberg San Francisco General - February 02, 2015The American College of Surgeons recently announced that M. Margaret Knudson, MD, FACS, Professor of Surgery and trauma surgeon at the San Francisco General Hospital and Trauma Center, has joined the Division of Member Services of the American College of Surgeons (ACS) as Medical Director for the Military Health System (MHS) Strategic-ACS Partnership. The partnership was officially launched with the signing of a charter during Clinical Congress 2014. Dr. Knudson will oversee the partnership and [...]
- UCSF Department of Surgery at Zuckerberg San Francisco General - May 20, 2014KRON4 in San Francisco reports on an innnovative game, developed by UCSF trauma surgeon, M. Margaret "Peggy" Knudson, MD, that teaches traffic safety to children. SFGate, the sister-site of the San Francisco Chronicle, discusses the game in depth: A group of third-graders waved their hands and screamed - "Stop!" - as a car slowly backed toward them from a garage.The children weren't in danger of becoming San Francisco's latest pedestrian casualties, though. They were one of many groups of [...]
- UCSF Department of Surgery at Zuckerberg San Francisco General - July 12, 2013UCSF News reports on the efforts of the trauma team at San Francisco General Hospital that treated victims of Asiana Airlines Flight 214 that crashed while landing in San Francisco in July 2013. The team included UCSF Department of Surgery trauma surgeons M. Margaret Knudson, M.D. and Andre Campbell, M.D., and Rachael A. Callcut, M.D., M.S.P.H.. They arrived at SFGH within hours of the disaster: On the morning of July 6, M. Margaret Knudson, MD, chief of surgery at SFGH, worked with Campbell [...]
- UCSF Department of Surgery at Zuckerberg San Francisco General - September 13, 2010M. Margaret Knudson, MD, FACS (center) was awarded the 2010 National Safety Council Surgeon's Award for Service to Safety at the Trauma Reception at the AAST Annual Meeting in Boston, MA. for her visionary leadership in injury prevention and control, and lifelong commitment to the care of injured patients that has saved countless lives." The award was presented by L.D. Britt, MD, FACS, ACS President and President of the American Association for the Surgery of Trauma (left) and Michael F. [...]
- UCSF Department of Surgery at Zuckerberg San Francisco General - June 15, 2009UCSF News reports on the SGFH-based San Francisco Injury Center Research and Prevention and its innovative research to to treat, understand and prevent traumatic injuries: For the past 20 years, the San Francisco Injury Center for Research and Prevention (SFIC) has been working to treat, understand and prevent traumatic injuries and to establish practices that serve as national and international models. Whether an injury is caused by a fall, a firearm or a motor vehicle crash, the [...]
