David Hom: Healing Facial Wounds with Science and Art

Doctor poses for a picture.

David Hom, MD, is senior editor of a heralded new textbook.

David Hom, MD, recruited to the Department of Otolaryngology-Head and Neck Surgery and the UC Gardner Neuroscience Institute in 2007, has achieved a career milestone with the publication of a definitive textbook on tissue healing of the face and neck. Dr. Hom, Professor of Otolaryngology and Director of the Division of Facial Plastic & Reconstructive Surgery at UC, is the senior editor of the textbook, which earned a review recently in the Journal of the American Medical Association (JAMA).

The JAMA reviewer of Essential Tissue Healing of the Face and Neck, G. Richard Holt, MD, of the Department of Otolaryngology at the University of Texas Health Science Center, predicted the textbook “will serve as the foundational guide to those who are learning, teaching, and practicing surgery.” Dr. Holt describes the book as “rich with theory, practical applications, and promise for the future.”

“I’m proud of the book,” Dr. Hom says. “In addition to being a labor of love, it fills a niche. A book addressing the problems of wound healing of the face in a contemporary fashion was needed.”

As senior editor, Dr. Hom enlisted the participation of co-editors and chapter authors from multiple specialties: otolaryngology, plastic surgery, oral maxillofacial surgery, dermatology and basic science. He also selected the topics and reviewed the text, which is divided into three parts:

  • Part 1 describes the unique healing aspects of each tissue of the face (skin, muscle, bone, nerve and mucosa) and the science behind the wound-healing process of each.
  • Part 2 describes what happens during poor wound healing, the clinical problems that arise, and current practices for treating wounds that don’t heal properly.
  • Part 3 is dedicated to newer and future therapeutic options.

Dr. Hom, who came to UCNI from the University of Minnesota, specializes in reconstructing the face and treating facial paralysis following trauma, tumor removal and radiation, with the dual goals of restoring function and maximizing the individual’s appearance. He is listed twice in the Best Doctors in America® database, in the practice of otolaryngology (ear, nose and throat) and plastic surgery. His versatile skills enable him to collaborate with specialists across three UCNI centers: Neurosensory Disorders, Neurotrauma and the Brain Tumors.

Dr. Hom, who had a penchant for sculpture and for building model boats and airplanes as a youth, was drawn to the anatomy of the head and neck while in medical school because of its functional importance and its three-dimensional structure. He was captivated by the intricate fusion of nerves, muscles, skin and mucosa — all packed in with the cranial nerves, the sensory and motor nerves that enable us to see, hear, smell, taste, feel and control facial movements. “Facial reconstructive surgery involves not only science, but a bit of artistry as well,” Dr. Hom says. “One has to try to create harmonious features of the face, to make them flow.”

The healing of facial wounds has been a passion of Dr. Hom’s for more than 20 years. He was fascinated not only by chronic, poorly healing wounds, but also by wounds that heal normally. During his resident research project at the University of Michigan, he began experimenting in the lab with growth factors — “signal proteins” that are described in his book as “the engines that drive wound healing” – in the hope that he might manipulate them into helping wounds heal more quickly and effectively. He continued his research at the University of Minnesota with funding from the National Institutes of Health.

Dr. Hom wanted to know whether one could hasten wound repair by adding certain growth factors to normal wounds. The idea of hastening normal wound-healing is “controversial,” Dr. Hom stresses. “A seasoned surgeon might argue, ‘If it’s going to heal anyway, why use something to make it heal faster?’ My answer is twofold: First, it would allow patients to leave the hospital sooner and would speed up their post-op course in healing, thus enabling them to return to work sooner. Second, if you can speed up healing, you might prevent other wound complications from occurring.”

In his lab, Dr. Hom and his co-investigators tested an “autologous platelet gel,” a concentrated plasma rich in growth factors that was derived from an individual’s own blood. During the pilot study, eight healthy volunteers allowed researchers to impose five skin-punch wounds, 4 millimeters in diameter, on each of their thighs. One thigh of each participant served as the control and was treated with conventional therapy, which included antibiotic ointment and a bandage; the wounds on the other thigh were treated with the participant’s own platelet gel. Over a period of 42 days, the wounds treated with platelet gel healed faster.

The study was published in the May/June 2007 issue of the Archives of Facial Plastic Surgery, not long after Dr. Hom arrived in Cincinnati. It was covered extensively by the mainstream media, including Reuters, the BBC and National Public Radio, as well publications like Scientific American and the MIT Technology Review.

Dr. Hom is continuing his research with growth factors at the University of Cincinnati. “Their potential in the future,” he says, “is enormous.”

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