Short abstract
Innovative microsurgeon who performed the world's first reported hand replant
Zhong Wei Chen, an internationally famous microsurgeon, published the world's first hand reattachment in 1963; 41 years later the patient is still alive and working, his hand functioning well.
Chen's doctor father was the president of a hospital and his mother a pharmacist. In 1948 he entered the French-funded Shanghai Second Medical College, where he did 10 times more cadaver dissections than the other students. His interest in surgery grew from this. He started postgraduate training in 1954 under Professor Yan Qing Ye, one of the founders of modern Chinese orthopaedics, at Shanghai Lister Hospital. On completion of his training he moved to the Shanghai Sixth People's Hospital, a national trauma centre, where he rapidly shone. Seven years after qualifying he performed the replantation that made him famous, publishing it in the Chinese Medical Journal ( 1963;82: 632). An American surgeon, Ronald Malt, had successfully replanted a child's amputated hand several months earlier but did not publish the case report until the child achieved functional recovery (Journal of the American Medical Association 1964;198: 716).
In 1966 Chen successfully replanted an amputated finger, and performed an arm replantation after segmental resection, thus allowing some functional restoration after tumour removal. In 1975 he successfully used a pectoral major muscle flap to reconstruct forearm muscles, and in 1977 he was the first to treat tibial pseudo-arthrosis with a vascularised fibula flap. In 1980 he was one of the first to recreate a missing thumb with a second toe. A year later he began vascularised nerve grafting: in two patients with substantial missing sections of the radial motor nerve he transplanted sections of sensory nerve, producing considerable functional recovery. In 1982 he developed pedicled iliac crest transfer for treating femoral head aseptic necrosis in children. By 1983 his group had carried out 1100 limb and digit replants.
He has been a visiting professor in 40 countries and has won many awards including presidency of the International Society for Reconstructive Microsurgery and the Chinese Qiu Shen Award for the top 10 Chinese scientists in history. Last year the Journal of Long-Term Effects of Medical Implants named Dr Chen outstanding scientist of 2003 for starting the modern era of replantation surgery and for the microsurgical techniques he developed.
Figure 1.
His microsurgery research laboratory studied methods of improving the patency of small vessels, invention of the “sleeve” microanastomosis for vessels less than 1 mm diameter, cold storage of the amputated extremity, effects of hyperbaric oxygen on ischaemic replants, motor nerve-plate regeneration after nerve repair, vascularised nerve grafting, bridging nerve defects with vascularised grafting, effects of Schwann cells on nerve regeneration, and improving nerve regrowth with Chinese herbs and nerve growth factors, and a search for animal models of clinical problems. He was the author of 92 papers in Chinese and 33 in English, and wrote 11 books.
His daughter, plastic surgeon Dr Lilly Chen of New York, said that his relationship with the Chinese regime was good, apart from the general opprobrium to which all intellectuals were subjected. However, David Evans, a hand surgeon from Windsor, told the BMJ that he felt this was not always so and that Dr Chen was sometimes prevented from visiting the West, where he was in great demand. He visited England in the early 1980s. When Mr Evans organised a visit of 18 UK orthopaedic surgeons to China they visited Chen and watched him do a toe-to-hand transplant in a very basic operating room, lit, it seemed, with a car headlight. Chen surreptitiously invited the group to his tiny flat; by the next day the authorities had heard about this, and questioned the party about any exchange of gifts.
Tall and athletic, Chen was a national javelin champion when young and remained a keen tennis player, and fit and athletic, all his life. Productive to the last, he never retired from research and teaching.
When he locked himself out of his seventh floor flat he tried to climb in from a balcony but the window was locked and, unable to turn around, he fell to his death.
He leaves a wife, Professor Hui Zhu Yin, an ear nose and throat specialist; and a son and daughter, who live in New York.
Zhong Wei Chen, resident surgeon, head of orthopaedics, and then deputy director Shanghai Sixth People's Hospital; chairman, department of surgery Zhong Shan Hospital, Shanghai, China (b Ningbo, Zhejiang province, China, 1929; q Shanghai Second Medical University 1954), died on 23 March 2004 after falling from his apartment block.