Susan E. Mackinnon, MD, FACS, FRCSC, the Sydney M. Shoenberg, Jr., and Robert H. Shoenberg Professor and chief, division of plastic and reconstructive surgery at Washington University School of Medicine, St. Louis, MO, received the 2013 Jacobson Innovation Award of the American College of Surgeons (ACS). The award was presented at a dinner held in Dr. Mackinnon’s honor June 7 at the The J.B. Murphy Memorial Auditorium Building in Chicago, IL.
The prestigious Jacobson Innovation Award, made possible through a gift from Julius H. Jacobson II, MD, FACS, and his wife Joan, New York, NY, honors living surgeons who have developed original and significant surgical techniques. Dr. Jacobson is a general vascular surgeon known for his pioneering work in the development of microsurgery. Unfortunately, Dr. and Mrs. Jacobson were unable to attend the dinner this year, but President A. Brent Eastman, MD, FACS, and Dr. Mackinnon commented on Dr. Jacobson’s many innovative contributions to surgery and expressed gratitude for the Jacobsons’ generosity to the College.
Pioneer in nerve transfer procedures
Dr. Mackinnon was selected to receive this year’s award because of her leadership in the innovative use of nerve transfer procedures for patients with devastating peripheral nerve injuries. Before Dr. Mackinnon’s pioneering work, which began in 1991, peripheral nerve injuries were genesrally treated with a procedure that involved repairing the nerve at the site of the injury with microsutures and expendable sensory nerves from elsewhere in the body to bridge a gap. However, this method had significant limitations, resulting in slow nerve regeneration and poor return of muscle function.
Rather than concentrating on the anatomical area of nerve injury, Dr. Mackinnon’s approach focuses on the motor endplates of the denervated muscle. This surgical technique involves working with expendable branches within major nerves near the compromised muscle. The nerve transfer procedure changes a high-level proximal injury (such as at the neck) to a more distal injury (such as at the axilla, arm, forearm, or hand) and avoids the detrimental impact of prolonged muscle denervation.
Previously, Dr. Mackinnon performed the first nerve transplant in 1988, using nerves from a cadaver to restore feeling and movement to a boy’s injured leg. This landmark operation began a quarter-century of novel work in nerve transplantation and led to many other surgical firsts. She has transplanted branches of the median nerve at the wrist to the ulnar nerve and from the median nerve to the radial nerve—the latter for patients with difficult high radial injuries associated with fractures of the humerus. Similarly, patients with previously disastrous brachial plexus injuries at the shoulder can now be treated with transfers of a nerve branch to the motor components of the median nerve for finger flexion and pronation and the ulnar nerve for intrinsic hand function.
In 2012, Dr. Mackinnon and her surgical team at Barnes-Jewish Hospital, St. Louis, received worldwide attention for a nerve transfer procedure that successfully enabled a quadriplegic patient to regain some use of one of his hands. This procedure was the first report of using nerve transfer to restore the ability to flex the thumb and index finger after a spinal cord injury.
Dr. Mackinnon’s groundbreaking work has produced a paradigm shift in the treatment of peripheral nerve injuries. Today surgeons use new nerve transfers to help patients around the globe. The practice has significantly improved care of patients with previously devastating peripheral nerve injuries who now experience a return of function only dreamed of in earlier generations. Legions of patients who have experienced returned function to their injured arms and legs have benefitted from Dr. Mackinnon’s insightful approach to developing nerve transfer operations.
Renowned educator and researcher
Dr. Mackinnon is a renowned teacher who has assumed the interdisciplinary training of an entire generation of specialists interested in the surgical treatment of peripheral nerve injuries, including neurosurgeons, orthopaedists, and plastic surgeons. She credits her remarkable success in the field to three decades of research funding support from the Medical Research Council in Canada and the National Institutes of Health in the U.S. In recent years, she has worked on a military-funded website that shares surgical procedures in step-by-step detail—“surgical recipes,” Dr. Mackinnon says, for disseminating information to a greater number of surgeons.
Dr. Mackinnon has been a prolific contributor to the medical literature, with more than 450 peer-reviewed manuscripts and 140 book chapters. She has received numerous awards, including the Royal College Medal Award in Surgery from the Royal College of Physicians and Surgeons of Canada in 1988. She has served in leadership positions for several surgical societies, most recently in 2012, as president of the American Association of Plastic Surgeons, and in 2007, she received the high honor of being elected a fellow of the Institute of Medicine of the National Academy of Sciences.
Born in Campbellton, New Brunswick, Dr. Mackinnon earned her medical degree at Queen’s University, Kingston, ON, where she performed her residency training in general surgery for three years. She completed her training in plastic surgery and a fellowship in neurosurgery research at the University of Toronto. She served as associate professor in the division of plastic surgery at the University of Toronto and served one fellowship year at Raymond Curtis Hand Center in Baltimore, MD. Dr. Mackinnon moved to the U.S. in 1991 and served as professor, division of plastic surgery, at Washington University School of Medicine, St. Louis, and has since held several medical leadership positions.