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The Charles Procedure: Misquoted and Misunderstood Since 1950

Dumanian, Gregory A. M.D.; Futrell, William J. M.D.

Plastic and Reconstructive Surgery: December 1996 - Volume 98 - Issue 7 - p 1258–1263
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The Charles procedure, named for Sir Richard Henry Havelock Charles, is an eponym for a surgical treatment of leg lymphedema. Sir Havelock led a fascinating life, with his travels taking him to India, the Afghan territories, and the Court of King George V of England.

At the turn of this century, Sir Havelock published material describing a series of 140 consecutive patients treated successfully for scrotal lymphedema. In a book chapter published a decade later, entitled “Elephantiasis Scroti,” Sir Havelock briefly described the treatment of leg lymphedema but did not document a single successful case report.

The name of Sir Havelock Charles was absent from the literature until 1950, when Sir Archibald McIndoe attributed the treatment of leg lymphedema with radical excision and skin grafting to Sir Havelock. References to Charles for the treatment of leg lymphedema have proliferated since that time.

Chicago, Ill., and Pittsburgh, Pa.

From the Division of Plastic and Reconstructive Surgery at Northwestern University and the Division of Plastic, Maxillofacial, and Reconstructive Surgery at the University of Pittsburgh. Received for publication September 27, 1995.

Presented at the Senior Residents' Meeting, in Ann Arbor Michigan, in May of 1995.

Gregory A. Dumanian, M.D.

Division of Plastic and Reconstructive Surgery Northwestern University Medical School 707 N. Fairbanks Court, Suite 811 Chicago, Ill. 60611-3042

©1996American Society of Plastic Surgeons