Wound V.A.C. Co-Inventors Receive Medallion of Merit Awards

Two Plastic and Reconstructive Surgery faculty at Wake Forest Baptist Medical Center, Louis Argenta, MD, FACS, professor and chairman emeritus, and Michael Morykwas, PhD, professor, are the 2015 recipients of Wake Forest University’s highest honor, the Medallion of Merit. Wake Forest University President Nathan O. Hatch presented the awards Feb. 19 at Founders’ Day Convocation in Wait Chapel on Wake Forest’s Reynolda Campus.

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Both Detroit natives joined the faculty at Wake Forest Baptist in 1988, bringing a collaboration between surgeon and laboratory researcher that continues today. They are best known for co-inventing Vacuum-Assisted Closure® (V.A.C.)®, a negative pressure wound therapy that has helped more than 10 million patients worldwide.

Argenta was acting chair of Plastic Surgery at the University of Michigan when he was recruited to lead the fledgling department here. Morykwas, a Michigan student who had just finished his doctoral thesis on skin substitutes for burn treatment, impressed him.

“I wanted to start a lab, and when I looked at the people who could do it, he was at the top of the list,” Argenta recalled.

“It has been a very good, synergistic relationship,” Morykwas said.

From a 179-square-foot space with a single technician, the lab has grown to an 8,500-square-foot facility with 25 researchers. Together with its large clinical practice, Argenta rates Wake Forest Baptist’s Department of Plastic and Reconstructive Surgery among the top five in the nation.

Argenta: The Surgeon
Argenta grew up an avid reader. He discovered books by humanitarian physicians Albert Schweitzer and Thomas Anthony Dooley III. By high school, he’d chosen medicine and was class president and valedictorian.

He completed his undergraduate degree, medical school and internship at the University of Michigan, Ann Arbor. The Vietnam War brought a three-year stint in the Navy, after which he returned to Michigan for residencies in general and plastic surgery.

In 1980, he received a fellowship opportunity in Paris with Paul Tessier, then the world’s foremost craniofacial surgeon. Craniofacial surgery is a subspecialty that deals with surgery of the skull, orbits and bones of the face.

“The Iran-Iraq War was raging, and we had injured Iranian teenage soldiers who had massive facial injuries on one side of the hospital and Iraqi teenage soldiers on the other,” he said. “We operated day and night, six days a week, and I got a huge amount of experience.”

He again returned to Michigan, where for the next seven and a half years, he was part of the largest clinical practice in the state, operating around the clock.

“I couldn’t do any research because there was just no time,” he lamented.

Then he was offered a job here to build a lab and department with control over time, personnel and finances. The Wound V.A.C. invention came as a byproduct of a last-ditch effort to treat a massive wound that had become infected and gaped open.

“Our patient was dying,” Argenta explained. “We had performed all the surgery we could, so the concept was to use a vacuum to pull the wound together, like an infinite number of stitches. Fortunately, it worked and he recovered.”

Gaining scientific acceptance and a patent took almost a decade.

“We tried to submit it for presentation at professional meetings and they told us it wasn’t scientific,” he recalled. “Journals accused us of being crazy, lying, and fabricating stuff. It was not pleasant, but the therapy was working, so we kept going.”

Eventually, its success could not be ignored, and Argenta received innovation awards from the American Association of Plastic Surgeons, American College of Surgeons, American Plastic Surgery Society, and the University of Michigan.

“It’s nice when your peers acknowledge that you did something significant, especially when previously many laughed and said you were crazy,” he noted.

Argenta and his wife, Ginger, a nurse he married during medical school, have eight children—several who are physicians. Over the years, the Argenta family has made medical missions to 25 nations, repairing cleft lips, palates and burns.

Morykwas: The Laboratory Researcher
Morykwas planned to be a dentist, but two years into dental school decided he was more interested in implants and biomaterials. He earned a bachelor’s degree in biology, and then master’s and doctoral degrees in bioengineering, all at the University of Michigan, Ann Arbor.

He describes early attempts to design a vacuum device for Argenta as “unsophisticated.”

“I would give him a device to try, and he would tell me what needed improvement,” Morykwas said. “It just slowly evolved.”

He ultimately trimmed a special sponge to the shape of the wound, connecting it to a vacuum pump via a tube. After wrapping the wound with airtight film, the negative pressure draws away fluid, reduces swelling, restores blood flow and shrinks the sponge, its edges pulling new tissue toward the center.

“We knew it worked from the results we saw in our patients,” he said. “We didn’t know how widespread it would become. After licensing it, when the nurses on the floor started asking if they could buy stock in the company, we knew it would be commercially successful.”

The full-time surgeon and full-time researcher complemented each other’s strengths.

“We researchers are very good at finding answers,” he mused. “We just don’t know what the questions are. Surgeons have tons of questions, but they often don’t have the time or resources to pursue answers, when they’re operating 12 hours a day.”

Although he never taught lecture courses, Morykwas has often interacted with graduate students in his lab. He served on Wake Forest Baptist’s Animal Care and Use Committee from 1991 to 2001 and its Library and Learning Resources Committee from 1992 to 1997, the final year as its chairman.

He is a member of more than a dozen professional organizations and served on the board of directors of the National Multiple Sclerosis Society, as well as supporting the local chapter. His dedication stems from losing his late wife to the disease. He has since remarried.

The Collaborative Setting
After tens of thousands of surgeries, Argenta retired from clinical practice in 2014, but he and Morykwas continue working on vacuum-based therapies. Two new applications are in early negotiations for licensing to industry by Wake Forest Innovations—one to treat the brain, another to treat the heart.

Both emphasized how important it has been to work at our Medical Center.

“Coming here from Michigan was an extremely good move,” Argenta said. “We probably could never have done a lot of this at most other medical centers. We had great support from the beginning, and things have worked out extremely well.”

“Wake Forest Baptist was the perfect size,” Morykwas said. “It was big enough to have all the facilities we needed, and the collegiality and congeniality here have made all the difference.”

Credit: This article originally appeared on the Wake Forest Baptist Medical Center Intranet

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