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Early Plastic Surgery Education through the Lens of Dr. Jerome P. Webster's Plastic Surgery Columbia Case Logs: 1943-1948
Alexander Dagi
*, Juliana Marquez, Christine H. Rohde, Jarrod T. Bogue
Columbia University, New York, NY
Background Jerome P. Webster (1888-1967), Columbia University's first professor of plastic surgery, is often called the father of plastic surgery education. This study analyzes Webster's archived case logs from 1943-1948 to understand early plastic surgery education and technical approaches that continue to shape contemporary training.
Methods We digitized and analyzed 820 procedures from Webster's case logs housed in Columbia University's medical library archive. Cases were categorized by anatomical location, technique, and etiology. Accompanying illustrations and several recovered patient notes were examined.
Results Webster's practice focused on head, face, and neck procedures (51.6%), with emphasis on ear reconstruction (107 cases), nasal procedures (94 cases), and lip repairs (46 cases). Hand and upper extremity cases constituted 15.3%, while breast and torso procedures represented only 5.5% of documented cases. Key techniques included pedicle flaps (121 cases), split-thickness grafting (57 cases), tube pedicles (28 cases), and cartilage grafting (17 cases). Primary etiologies included burn reconstruction (13.7%), congenital anomaly correction (8.7%), and scar management (16.3%). Webster's surgical illustrations served as crucial teaching tools, documenting complex procedures like tube pedicle grafts and nasal reconstruction. Patient notes written by residents revealed Webster's mentorship model emphasizing real-time clinical decision-making and intraoperative adaptations.
Conclusion Webster's case logs reveal historical differences and enduring principles in plastic surgery education. While contemporary practice shows significant shifts toward breast reconstruction and body contouring, Webster's educational methodology"”emphasizing visual teaching, mentored training, and systematic documentation"”established a framework that continues to influence modern surgical training. Moreover, Webster's legacy demonstrates that technical competence, reconstructive inventiveness, and clinical judgment have always been the foundations of the field.
