Scott is the Chair of the Department of Orthopedic Surgery at Penn Medicine as well as the Director of the Hand Transplant Program at Children’s Hospital of Philadelphia. Scott heads the Vascularized Composite Allotransplantation (VCA) Program and, after a series of tests and challenges, performed one of the first successful hand transplants in America. In 2015, Scott led the team that performed the world’s first bilateral hand transplant in a child. Even with all of this success in his field, Scott explains his method of continually improving himself and his practice on his pursuit of excellence.
Transcript
My particular area of interest in medicine and hand surgery is extremity reconstruction. Because I trained in plastic surgery after orthopedics and was Chief of the Division of Plastic Surgery at Duke for almost 15 years, before I became Chairman of Orthopedics here, I've sort of combined orthopedics and plastic surgery into a specialty called Orthoplastic Surgery. Part of that is a heavy reliance on the tools and the techniques of microvascular surgery, which is the coaptation or sewing together of small vessels, small blood vessels, under the microscope. Somebody amputates their finger, we reattach is using the microscope. Most of the patients we see, for consideration of hand transplantation, have sustained a severe illness, usually infection and because of the drugs that the patients were put on to sustain them, to keep them alive, the peripheral tissues, the hands and the feet, the arms and the legs, lose their blood supply and become necrotic, they die. So, patients require amputations and the patients that we looked at are what we call quadrimembral amputees. That means they have no arms or legs. In 1998, the first hand transplantation was done in the world, in France. It was a technical success but a clinical failure. In 1999, the first patient was operated on in the United States by a colleague of mine and one of my mentors from Louisville, Warren Breidenbach. And that patient still has his hand today. He's a public figure, his name is Matt Scott. So, fast forward with my keen interest in microvascular surgery and the evolution of reconstructive surgery, I got interested in hand transplantation and, was unsuccessful despite my research work at Duke and enthusiasm for taking this new dimension of reconstructive surgery and bringing it to the reality in an institution. I came to Penn in 2009, unsuccessful at Duke, and within two years, we did our first hand transplant with the support of the institution, and a cast of my partners and orthopedics and plastic surgery and transplant surgery and nursing and anesthesia. It was sort of, it takes a village, to use the cliche. So, we did our first transplant in 2011, after two years of preparation. Then, the world's first hand transplant in a child, was done in 15 and a year later, we did another bilateral lady, our first international patient that's ever been transplanted sort of across the pond. She came from Paris, France to us and we have several other patients, both adults and children now, that we're evaluating.
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