May 28, 2008
Pablo Prichard, MD, has a passion for rebuilding the faces, limbs and lives of traumatic injury victims.
Pablo Prichard, MD, chair of plastic surgery at John C. Lincoln North Mountain Hospital.
Plastic surgery goes beyond skin deep. In the right hands, plastic surgery can rebuild a face crushed in a car crash or a foot mangled in a motorcycle accident.
Transforming the lives of people who have suffered traumatic injury is a passion for Pablo Prichard, MD, chief of plastic surgery at John C. Lincoln North Mountain Hospital.
"I was lucky he was on duty that day," recalls William Freeman, 58, who nearly lost his foot in a motorcycle accident during the holidays. "My foot was caught between the motorcycle, road and a flatbed truck. It was mangled — the heel ripped off and the foot just crushed."
William's loved ones feared that his foot would be amputated, but Dr. Prichard said it could be saved. "He rebuilt my foot for me," says William. "It looked like hamburger meat before, and now it looks like a normal foot."
Bryan England was in an ATV crash in the spring, and the 26-year-old's face was crushed by the vehicle. He arrived at the North Mountain Trauma Center unconscious, with multiple injuries.
"I was wearing a helmet, but Dr. Prichard had to rebuild my lips, tongue and face," says Bryan, whose accident came after two recent losses in his family. "My family has been through a lot, and the people at John C. knew that and helped us so much."
Successful reconstruction requires that plastic surgeons suture blood vessels only one to two millimeters wide. Advances in technology allow surgeons to rebuild tissue at this microvascular level, including the harvesting of skin, muscle and bone from other areas of the body.
"Often a patient's body is so severely injured that large tissue grafts are required to replace missing or crushed structures and tissue," Dr. Prichard explains. He notes that these procedures require special microsurgical equipment and techniques, such as microscopes, fiber optics, angiograms and three-dimensional CT scans.
Dr. Prichard works closely with other physicians in the Emergency and Level I Trauma Center at North Mountain. He helps evaluate when patients arrive with injuries such as facial traumas or shattered limbs. When appropriate, he begins immediate reconstructive work.
"The sooner we start treatment, the more realistic a result we can get," says Dr. Prichard. "This is especially true of facial injuries. Once bones have started to heal, it's more difficult to achieve pre-traumatic results."
Reconstructive surgery can involve any number and combination of plates, surgical screws, synthetic implants and grafts of bone, nerves, muscle and skin to help restore function as well as appearance of damaged tissues. Thanks to top-notch facilities and staff, Dr. Prichard says, "We have an almost 100% success rate with the grafts we've done over the past two years."
Depending on the extent of injuries, the initial reconstruction process can take one to two months. At this point, many patients regain mobility in damaged limbs and craniofacial structures. Cosmetic refinements often take place a year later.
William's extreme injury has required 21 procedures in 14 months, with a handful more to come. To still have both feet and the ability to walk on them, he says, "It's all worth it."
As a reconstructive surgeon, Dr. Prichard in no way works alone. Facial injuries may involve neurological trauma and leg injuries, orthopedic trauma. In such cases, Dr. Prichard works with top trauma surgeons, neurosurgeons and orthopedic surgeons, plus a network of other specialists, to determine the best course of treatment.
"It's a team approach," says Dr. Prichard. He acknowledges the many public service employees and John C. staff members involved in a patient's care from accident site to emergency room to operating room and rehabilitation. "My specialty is one of many that contributes to the kind of care we're proud to provide."
"I had a lot of injuries and still have a lot of recovery ahead of me," says Bryan, "but what Dr. Prichard and his team have done is tremendous."
"It's rewarding to see someone's outlook on life change on so many levels," says Dr. Prichard. "We can help restore the function in people's bodies and a normal appearance in society. To see the appreciation in patients' eyes is truly rewarding."
Return to main News page.