Richard F. Edlich
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Richard F. Edlich (January 19, 1939,
New York City New York, often called New York City or NYC, is the List of United States cities by population, most populous city in the United States. With a 2020 population of 8,804,190 distributed over , New York City is also the L ...
, New York – December 25, 2013,
Brush Prairie, Washington Brush Prairie is a census-designated place (CDP) in Clark County, Washington, United States. The population was 2,652 at the 2010 census, up from 2,384 at the 2000 census. Based on per capita income, one of the more reliable measures of afflue ...
) was a Professor Emeritus of
Plastic Surgery Plastic surgery is a surgical specialty involving the restoration, reconstruction or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes craniofa ...
,
Biomedical Engineering Biomedical engineering (BME) or medical engineering is the application of engineering principles and design concepts to medicine and biology for healthcare purposes (e.g., diagnostic or therapeutic). BME is also traditionally logical sciences ...
and Emergency Medicine at the
University of Virginia Health System The University of Virginia Health System is an academic health care center associated with the University of Virginia in Charlottesville. The health system includes a medical center (with main hospital, children's hospital, and clinic network), ...
. His basic clinical and research interests focused on improving the safety and outcome of
wound care The history of wound care spans from prehistory to modern medicine. Wounds naturally heal by themselves, but hunter-gatherers would have noticed several factors and certain herbal remedies would speed up or assist the process, especially if it was ...
in emergency medicine and surgery.


Biography

He was admitted to
Lafayette College Lafayette College is a private liberal arts college in Easton, Pennsylvania. Founded in 1826 by James Madison Porter and other citizens in Easton, the college first held classes in 1832. The founders voted to name the college after General Laf ...
at age 15, after finishing his sophomore year at
Stuyvesant High School Stuyvesant High School (pronounced ), commonly referred to among its students as Stuy (pronounced ), is a State school, public university-preparatory school, college-preparatory, Specialized high schools in New York City, specialized high school ...
in New York City. Three years later, he enrolled as an early admission student at
New York University School of Medicine NYU Grossman School of Medicine is a medical school of New York University, a private research university in New York City. It was founded in 1841 and is one of two medical schools of the university, with the other being the Long Island School of ...
. After graduating from there in 1970, he began a surgical residency at the University of Minnesota Health Sciences Center, and received a Doctor of Philosophy in Surgery.


Academic career

After Edlich completed his 8-year residency training at the University of Minnesota Hospital, he completed a 2-year plastic surgical residency at the University of Virginia Health Sciences Center. During his time at the
University of Virginia School of Medicine The University of Virginia School of Medicine (UVA SoM) is the graduate medical school of the University of Virginia. The school's facilities are on the University of Virginia grounds adjacent to Academical Village in Charlottesville, Virginia. ...
, both in his residency and subsequent career, he published hundreds of publications and book chapters on burn care, wound healing, surgical instrument design, and rehabilitation. As well as beginning his research career in his time there, he was involved in the development of the burn unit and prehospital care service at the University of Virginia Health Sciences Center.


Emergency medicine

He accepted a position as director of an emergency room at the University of Virginia, where he made several advances in emergency care: an emergency medical communication system for ambulances, emergency training for ambulance attendants, a rape crisis center, a crisis center for the deaf, a poison control center, an advanced life support emergency medical system, and the first medical air transport system in the
Commonwealth of Virginia Virginia, officially the Commonwealth of Virginia, is a U.S. state, state in the Mid-Atlantic (United States), Mid-Atlantic and Southeastern United States, Southeastern regions of the United States, between the East Coast of the United Stat ...
. Edlich was selected as one of the eight physician technical advisors for the Department of Emergency Medical Services in the Department of Health Education and Welfare to develop emergency medical systems throughout the US. He supervised the development of emergency medical systems in the Commonwealth of Virginia, Pennsylvania, West Virginia, Maryland, Washington DC, and Puerto Rico. In 1979, Edlich received the Distinguished Public Service Award for Contributions to Emergency Medicine by the
US Public Health Service The United States Public Health Service (USPHS or PHS) is a collection of agencies of the Department of Health and Human Services concerned with public health, containing nine out of the department's twelve operating divisions. The Assistant S ...
.


Professional accomplishments

In his studies of the biology of wound repair and infection, he designed the first adhesive skin closure tape that could approximate the wound edges without the use of sutures. He developed a skin wound cleanser safe enough to be poured into the patient's eye without toxic effects, a solution of poloxamer 188 that has now been approved for use by the
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
(FDA) and is now marketed as Shur-Clens by
Convatec Convatec Group plc is a medical products and technologies company based in Reading, Berkshire, England. offering products and services in the areas of wound and skin care, ostomy care, continence and critical care and infusion devices. It is liste ...
(Skillman, New Jersey). Realizing the drawbacks of the Bovie electrical generator for
electrosurgery Electrosurgery is the application of a high-frequency (radio frequency) alternating polarity, electrical current to biological tissue as a means to cut, coagulate, desiccate, or fulgurate tissue.Hainer BL, "Fundamentals of electrosurgery", ''Jou ...
, Edlich developed the first compact electrosurgical unit.


Endoscopy

After Edlich learned about
endoscopes An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inse ...
in
Asia Asia (, ) is one of the world's most notable geographical regions, which is either considered a continent in its own right or a subcontinent of Eurasia, which shares the continental landmass of Afro-Eurasia with Africa. Asia covers an area ...
, he received an endoscope for gastroscopic visualization of the patient's stomach. As a surgical resident, Edlich was the first physician to do a gastroscopy at the University of Minnesota Medical Center. Edlich's picture was featured on the cover of Postgraduate Medicine, the Journal of Applied Medicine, in November 1968. His experiences with gastroscopy led to the first minimally invasive surgical procedure at the University of Minnesota Hospital, an
endoscopic An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are insert ...
gastrostomy Gastrostomy is the creation of an artificial external opening into the stomach for nutritional support or gastric decompression. Typically this would include an incision in the patient's epigastrium as part of a formal operation. It can be perfor ...
. Edlich soon realized the limitations of the thick, narrow-diameter latex Ewald tubes that were being used to evacuate
blood clots A thrombus (plural thrombi), colloquially called a blood clot, is the final product of the blood coagulation step in hemostasis. There are two components to a thrombus: aggregated platelets and red blood cells that form a plug, and a mesh of cr ...
from the patient's stomach before endoscopic examination. Edlich devised a thin-walled, transparent, plastic tube for evacuation of blood clots from a patient's stomach.


Ischemic myocardium

Edlich helped to quantitate the
perfusion Perfusion is the passage of fluid through the circulatory system or lymphatic system to an organ or a tissue, usually referring to the delivery of blood to a capillary bed in tissue. Perfusion is measured as the rate at which blood is deliver ...
of a
saphenous vein graft The great saphenous vein (GSV, alternately "long saphenous vein"; ) is a large, subcutaneous, superficial vein of the human leg, leg. It is the longest vein in the body, running along the length of the lower limb, returning blood from the foot, hu ...
implanted in canine
ischemic Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems wi ...
myocardium Cardiac muscle (also called heart muscle, myocardium, cardiomyocytes and cardiac myocytes) is one of three types of vertebrate muscle tissues, with the other two being skeletal muscle and smooth muscle. It is an involuntary, striated muscle that ...
using tissue blood flow measurements. When his studies failed to show
revascularization In medical and surgical therapy, revascularization is the restoration of perfusion to a body part or organ that has had ischemia. It is typically accomplished by surgical means. Vascular bypass and angioplasty are the two primary means of reva ...
of the heart, he suggested that the revascularization of the heart could be improved by a
coronary artery bypass graft Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage") is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest pai ...
.


Burn and wound healing center

Edlich's interest in
emergency medical care Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuously learn to care for unsche ...
was complemented by his clinical experience in burn care. After accepting the position as Director of University of Virginia Burn Center, which initially consisted of only two beds, he enlisted the help of benefactors as well as the
University of Virginia The University of Virginia (UVA) is a Public university#United States, public research university in Charlottesville, Virginia. Founded in 1819 by Thomas Jefferson, the university is ranked among the top academic institutions in the United S ...
to develop the 16-bed DeCamp Burn and Wound Healing Center, which included a hyperbaric oxygen treatment system for patients with
necrotizing fasciitis Necrotizing fasciitis (NF), also known as flesh-eating disease, is a bacterial infection that results in the death of parts of the body's soft tissue. It is a severe disease of sudden onset that spreads rapidly. Symptoms usually include red or p ...
and
purpura fulminans Purpura fulminans is an acute, often fatal, thrombotic disorder which manifests as blood spots, bruising and discolouration of the skin resulting from coagulation in small blood vessels within the skin and rapidly leads to skin necrosis and disse ...
. He helped to devise a new
silver sulfadiazine Silver sulfadiazine, sold under the brand Silvadene among others, is a topical antibiotic used in partial thickness and full thickness burns to prevent infection. Tentative evidence has found other antibiotics to be more effective, and therefore ...
cream containing
poloxamer Poloxamers are nonionic triblock copolymers composed of a central hydrophobic chain of polyoxypropylene (poly(propylene oxide)) flanked by two hydrophilic chains of polyoxyethylene (poly(ethylene oxide)). The word was coined by BASF inventor, I ...
188 that exhibits less tissue toxicity than that of the commercially available silver sulfadiazine cream. Edlich devised a new
Gram stain In microbiology and bacteriology, Gram stain (Gram staining or Gram's method), is a method of staining used to classify bacterial species into two large groups: gram-positive bacteria and gram-negative bacteria. The name comes from the Danish ...
technique for quantitative
bacteriology Bacteriology is the branch and specialty of biology that studies the morphology, ecology, genetics and biochemistry of bacteria as well as many other aspects related to them. This subdivision of microbiology involves the identification, classificat ...
using stable
iodophor An iodophor is a preparation containing iodine complexed with a solubilizing agent, such as a surfactant or water-soluble polymers, for example, povidone (forming povidone-iodine). The result is a water-soluble material that releases free iodine ...
s rather than unstable aqueous iodine. This reliable Gram stain technique is now being used throughout the world. When Edlich treated burn patients in which the patient's ignited clothing was adherent to the burned skin, he was concerned that the adult textiles were highly flammable and became the ignition source for the burn injury. His clinical measurements of fabric flammability of the textiles as well as a careful review of the ignition source documented that flammable liquids, such as gasoline, were the ignition sources of most burn injuries. Consequently, Edlich initiated a nationwide educational program that has dramatically reduced the frequency of burn injuries stemming from flammable liquids.


Surgical gloves

During his surgical career, Edlich and his team of scientists made important scientific contributions that have protected health care workers as well as operating room personnel. His studies on the toxicity of
corn starch Corn starch, maize starch, or cornflour (British English) is the starch derived from corn (maize) grain. The starch is obtained from the endosperm of the kernel. Corn starch is a common food ingredient, often used to thicken sauces or sou ...
became a catalyst for the development of powder-free gloves. His scientific investigation proved conclusively that cornstarch was a dangerous foreign body that potentiated wound infection and was a vector for the
latex allergy Latex allergy is a medical term encompassing a range of allergic reactions to the proteins present in natural rubber latex. It generally develops after repeated exposure to products containing natural rubber latex. When latex-containing medical de ...
epidemic. On September 24, 2008, Edlich and eleven health professionals submitted a Citizen's Petition to the FDA to ban cornstarch on
medical gloves Medical gloves are disposable gloves used during medical examinations and procedures to help prevent cross-contamination between caregivers and patients. Medical gloves are made of different polymers including latex, nitrile rubber, polyvinyl ...
(FDA-2008-P-0531). On February 3, 2011, the FDA prepared a
Federal Register The ''Federal Register'' (FR or sometimes Fed. Reg.) is the official journal of the federal government of the United States that contains government agency rules, proposed rules, and public notices. It is published every weekday, except on feder ...
on the safety and performance of medical gloves with cornstarch, in which healthcare professionals had 60 days to make comments that ultimately led to the FDA's final decision regarding banning cornstarch on medical gloves. Edlich's studies on a new powder-free double-glove puncture indication system support the use of this double-glove system in surgical procedures in an effort to prevent the spread of deadly blood-borne
viral infection A viral disease (or viral infection) occurs when an organism's body is invaded by pathogenic viruses, and infectious virus particles (virions) attach to and enter susceptible cells. Structural Characteristics Basic structural characteristics, s ...
(Molnlycke Healthcare, LLC, Norcross, Georgia)


Afflictions

Edlich suffered from
multiple sclerosis Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This d ...
, and was eventually confined to a wheelchair. At one point, he suffered a broken
femur The femur (; ), or thigh bone, is the proximal bone of the hindlimb in tetrapod vertebrates. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with ...
when his wheelchair brake failed.


Awards

Edlich's contributions to teaching and healthcare have been recognized by the following Awards: 1990 Thomas Jefferson Award from the
University of Virginia The University of Virginia (UVA) is a Public university#United States, public research university in Charlottesville, Virginia. Founded in 1819 by Thomas Jefferson, the university is ranked among the top academic institutions in the United S ...
, Distinguished Alumni Award from the University of Minnesota Medical Alumni Association (2005), James D. Mills Award from the
American College of Emergency Physicians The American College of Emergency Physicians (ACEP) is a professional organization of emergency medicine physicians in the United States. The organization was founded August 16, 1968, by eight physicians in Lansing, Michigan. ACEP established ...
(2008), and the Solomon A. Berson Award in Health Sciences from the
New York University School of Medicine NYU Grossman School of Medicine is a medical school of New York University, a private research university in New York City. It was founded in 1841 and is one of two medical schools of the university, with the other being the Long Island School of ...
(2011).


References


External links


A Tribute to Richard F. Edlich
{{DEFAULTSORT:Edlich, Richard F. 1939 births 2013 deaths American plastic surgeons University of Virginia School of Medicine faculty