David Colen, MD

Dr. David Colen’s research program is focused on advancing the science, practice, and delivery of hand surgery and extremity reconstruction through a multidisciplinary “orthoplastic” approach that integrates plastic, orthopedic, and vascular surgery. His body of scholarship spans three interconnected domains: clinical innovation, health services and socioeconomic analysis, and bioethical inquiry, each reinforcing the other to improve outcomes and expand access to high-quality reconstructive care.

Clinical and Translational Research Dr. Colen’s clinical research has advanced techniques in microsurgical reconstruction for trauma, oncologic, and degenerative conditions of the extremities. He has published extensively on vascularized bone grafting, including seminal work demonstrating the safety and efficacy of the medial femoral condyle (MFC) flap in pediatric patients. This work has broadened indications for vascularized skeletal reconstruction and established Yale as a national leader in limb salvage and pediatric microsurgery. Additional projects have focused on improving tendon repair techniques, expanding donor site applications, and optimizing microvascular monitoring to enhance flap survival. Through close collaboration with vascular surgery, he has also pioneered the application of venous arterialization techniques for upper extremity salvage. These efforts collectively represent a sustained commitment to surgical innovation that directly impacts patient outcomes.

Health Services and Socioeconomic Research In parallel, Dr. Colen has developed a robust health services research program that investigates the economic efficiency, value, and accessibility of hand surgery. Utilizing large national databases and EHR platforms such as Medicare, NEISS, TriNetX, and Epic Cosmos, his team has defined trends and cost drivers in wide-awake hand surgery. His studies have demonstrated that procedures such as carpal tunnel release, trigger finger release, and flexor tendon repair can be performed safely in ambulatory or office-based settings, achieving substantial cost savings without compromising outcomes. This work has been highlighted through editor’s choice recognitions, national journal clubs, and podium presentations, underscoring its significance in shaping the national dialogue around value-based surgical care. Ongoing projects extend this framework to fracture management and pediatric populations, with particular emphasis on how insurance status, comorbidities, and geography influence access to limb salvage procedures.

Bioethics and Patient-Centered Care Dr. Colen has also contributed to the bioethical discourse surrounding complex surgical decision-making. His work on digit replantation, a procedure that straddles the line between emergency and elective care, has highlighted the unique challenges of achieving true informed consent in time-sensitive, high-stakes situations. These studies propose ethical guidelines and best practices to improve patient education, align care with patient values, and support shared decision-making in reconstructive surgery.

Impact and Future Directions Taken together, Dr. Colen’s research portfolio reflects a cohesive program that bridges technical innovation, systems-level analysis, and ethical considerations in extremity reconstruction. His work has directly influenced clinical practice, reduced the economic burden of surgical care, and advanced national conversations on access and equity in hand surgery. Looking forward, he aims to expand his outcomes research using large-scale datasets, refine cost-effectiveness analyses for reconstructive procedures, and continue developing ethical frameworks for patient-centered surgical decision-making. These efforts align with Yale School of Medicine’s mission to integrate excellence in clinical care, education, and scholarship, while positioning Dr. Colen as an emerging national leader in orthoplastic surgery.