Annals of plastic surgery
-
Annals of plastic surgery · May 1993
Biography Historical ArticleA reconstructive surgeon's taste in art: Dr Peter Parker and the Lam Qua oil paintings.
Hidden within the basement archives of Yale University's Historical Medical Library lie the original oil painting collection and personal papers of the first American surgeon to practice in China. The Reverend Dr Peter Parker, a graduate of Yale, established the first American hospital in Guangzhou (formerly Canton) in 1835 and successfully introduced Western surgical techniques including amputation, anesthesia, and reconstructive surgery. In addition to this distinguished career of medical missionary service, Parker commissioned the Chinese artist Lam Qua to paint a fascinating series of portraits depicting patients with extreme tumor growths. ⋯ Selected examples of the Lam Qua paintings are presented along with Parker's corresponding patient descriptions. These detailed patient reports give insight into the extent of surgical pathology as well as the relative brutality of surgical techniques in the early to mid-1800s. The historical significance of the Peter Parker-Lam Qua collaboration within the context of the Western transformation of Chinese art and medicine is also discussed.
-
Annals of plastic surgery · May 1993
Case ReportsSuccessful treatment of coccidioidomycosis osteomyelitis in an infant.
A 10-month-old Hispanic male infant with expansile lesions of the third metacarpal and proximal phalanx positively diagnosed as Coccidioides immitis osteomyelitis is presented. Treatment consisted of combined surgical debridement and systemic antifungal therapy and resulted in complete resolution of the lesions. Treatment was guided by clinical response and complement fixation titers. ⋯ Neonates and infants appear to be more susceptible to the development of dissemination, but less likely to develop toxicity due to systemic therapy. Current therapy consists of concomitant surgical excision of involved lesions and systemic antifungal therapy. Complement fixation titers correlate closely with clinical response to therapy and are useful in detecting subclinical recurrences.
-
Annals of plastic surgery · May 1993
Case ReportsThe expanded forehead flap for nasal reconstruction.
A 3-year experience using forehead tissue expansion for nasal reconstruction is presented. The series includes 7 expansions in 6 patients with different degrees of nasal loss due to either cancer, trauma, or avascular necrosis. Balloon tissue expansion minimizes the well-known limitations and drawbacks found in using forehead flaps for nasal reconstruction. ⋯ The complications of tissue expansion are few, but obtaining a satisfactory nasal reconstruction requires multiple operations over a period of time. A learning curve is necessary due to inadequate previous experience and new developments in tissue expanders. The results obtained were possible due to the excellent tissue provided by forehead expansion.