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Today@Sam Article


Project 'Reconstructing' History Opens Doors For Surgical Internship

March 5, 2015
SHSU Media Contact: Romney Thomas

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Meagan Nolen
Biomedical sciences major Maegan Nolen has always been interested in plastic surgery. She used that interest in her History 1301 class as the starting point for a research project, which ultimately helped her acquire an internship in the field. —Photos by Brian Blalock


When one thinks about the words war, art, and plastic surgery, it’s difficult to imagine a link between the three topics. However, it’s these seemingly unrelated concepts that afforded a Sam Houston State University student the opportunity to learn and work in an operating room in Houston last summer.

Junior biomedical sciences major Maegan Nolen didn’t always know what she wanted to study in college, or if she even wanted to attend college at all.

“I moved around a lot growing up,” Nolen said. “I went through a rough patch in high school where I was really just disinterested in everything we were supposed to be learning. I didn’t attend classes, and I wanted to drop out.

“I had a good mentor though. She didn’t give up on me, so I graduated and began attending college. A year after starting college, my family moved to Texas and I transferred to Sam Houston.”

In spring 2013, Nolen enrolled in Rosanne Barker’s History 1301 class, where she was informed about the Undergraduate Research Symposium, sponsored by the Elliott T. Bowers Honors College. She decided she wanted to participate and began considering potential research topics.

'Reconstructing' History

Plastic surgery was developed thousands of years ago. Some early key procedures included:

  • The Indian method, a version of modern rhinoplasty
  • The Italian method, a later version of rhinoplasty
  • World War I, plastic surgery became a more common practice as doctors cared for injured soldiers, including prosethetic-like masks that were developed to hide injuries
  • World War II, modern grafting techniques were developed

“I’d always been interested in plastic surgery,” Nolen said. “In high school I used to frequent cosmetic surgery forums online, but I didn’t really know much about the history of plastic surgery.

“I learned about procedures that were developed thousands of years ago, like the Indian method, a primitive version of the modern rhinoplasty procedure. People would take a flap of skin from the forehead and rotate it downward to cover a mutilated nose,” she said. “Later, the Italian method was developed where people would attach skin from their upper arm to their nose and hold their arms up by their face for months to allow for the healing process.

“Studying these procedures and improving them allowed doctors to advance medical care and plastic surgery for those injured in World War I. That was when plastic surgery really kicked off and became a more common practice.”

Through her research for the undergraduate symposium, Nolen found an interesting link between the worlds of science and medicine and the world of art.

“In World War I, photography was becoming accessible, but there was a great number of influential pastel and watercolor artists,” she said. “Henry Tonks was a surgeon and an artist, and he used his artistic talents to record a lot of the injuries that people endured during the war.”

The art was used to record the injuries and the progression of the surgeries that war inflicted on those who fought. Soldiers were often given the pieces of art as mementos of their struggle after their discharge from the hospital.

Influential artists such as the sculptor Anna Coleman Ladd used their art to help soldiers in a different way. Ladd would use photographs of soldiers prior to their injuries to construct masks of their likeness that could be worn in public. In a way, that was one of the earliest forms of modern facial reconstruction.

Nolen continued to research how different surgery techniques were developed over time. Major progress was made during World War II concerning techniques used to treat burn victims.

“Modern skin grafting was developed during World War II,” said Nolen. “The techniques used today are essentially the same in that doctors would take skin from one area of the body in order to give it to an area in need.

“I wasn’t exactly sure where all this research would take me,” said Nolen. “But it turned out to be really important when I was looking for opportunities to study medicine in Houston.”

Meagan NolenWhen Nolen initially applied to participate in the University of Texas at Houston medical school’s summer undergraduate program, she was rejected, but a few days after receiving her letter of rejection, she received a different letter.

“Dr. David Wainwright, a plastic surgeon in Houston, actually chose me to work with him,” said Nolen. “In my application essay, I wrote about the research I had done, and he was so impressed with the research I did on my own that he offered me the opportunity to work with him over the summer.”

Through her research program, Nolen was able to shadow Wainwright as he worked for two months. She learned how to scrub in to an operating room and was able not only to observe surgeries as they happened, but also to assist.

“It was fascinating but difficult. People can get severely injured so often and so easily,” said Nolen. “For two months I really got to see first hand what doctors are capable of doing with plastic surgery.”

In particular, Nolen was able to see what she learned about burn victims in World War II in modern practice.

“It was really fascinating to watch the harvesting of skin grafts and the body’s revascularization with split-thickness grafts,” she said. “Split-thickness is the epidermis and some dermis depending on the situation, and it turns pinkish as it heals.

“I was also able to observe full-thickness grafts which include the epidermis and the entire dermis. Unfortunately with these grafts the donor site will be left with a wound that must be primarily closed through sutures. Split-thickness graft donor sites heal naturally with cells migrating upwards from sweat glands and hair follicles to re-epithelialize and reform the epidermal layer. In these cases though, the first priority is restoring function and appearance comes second.”

The opportunity to work with Wainwright in Houston has opened doors that Nolen hadn’t considered possible before.

“Before I did this research project and I was allowed to work closely with Dr. Wainwright, I didn’t even think I had a chance at getting into medical school,” she said. “Now that I’ve had these opportunities, I think I could even get into a really prestigious school. This has given me a lot more confidence about possibilities for my future.”

While Nolen was able to benefit hugely from the experience, it also gave her a new perspective about plastic surgery.

“I wish there wasn’t a need for plastic surgery, but Dr. Wainwright liked to say that people aren’t lizards. We don’t grow missing appendages back on our own.

“Now though, researchers and plastic surgeons are developing new ways to grow and repair parts of the human body. They are working to eventually grow skin from a few cells and to be able to grow human organs in a lab,” she said. “I wish there was some magic way to make it possible for people to completely heal their injuries on their own, but there isn’t. That’s why we have plastic surgery.”




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