Regrowing limbs could be the future for military medicineA juvenile California tiger Salamander migrates across the Travis Air Force Base, California, airfield in search of a suitable burrow, June 9, 2017. Military researchers are studying how some animals, such as salamanders, are able to regrow limbs. The work is designed to help those with amputations regrow their own arms and legs. (U.S. Air Force photo/ Heide Couch)For some animals, such as salamanders, regrowing a missing limb is a common healing process. But what if people could do the same? Could the future of treating amputations include warfighters regrowing their own muscle, bone, and nerve tissues?
“We’re not quite there yet,” said Army Lt. Col. David Saunders, extremity repair product manager for the U.S. Army Medical Material Development Activity, Fort Detrick, Maryland. “What we’re trying to do is develop a toolkit for our trauma and reconstructive surgeons out of various regenerative medicine products as they emerge to improve long-term outcomes in function and form of injured extremities.”
Army Lt. Col. David Saunders, the extremity repair product manager for the U.S. Army Medical Material Development Activity, Fort Detrick, Maryland, talks about extremity regeneration at the Military Health System Research Symposium in Kissimmee, Florida, Aug. 28, 2017.Saunders was part of a session focusing on the research being done on extremity regeneration, part of a larger theme of regenerative medicine at the Military Health System Research Symposium. The meeting this week in Kissimmee, Florida, brings together clinicians, researchers, academics, and administrators to focus on the unique medical needs of the military. Saunders said while there’s been amazing progress in the areas of using synthetic grafts to start the regrowth of muscle, nerve, vascular, and connective tissues, it’s still not the same as the real thing. “We would like it to be as restorative as possible, resist infection … and be durable,” he said. “This is going to be implanted in young people who may go on to live another 60 to 70 years.”
One researcher is using fillers to bridge the gap in damaged bones, hoping to figuratively bridge the gap between current regenerative techniques and the ideal: people regrowing lost limbs. Stephanie Shiels with the U.S. Army Institute of Surgical Research, Fort Sam Houston, Texas, talked about her research to develop a synthetic bone gap filler that heals bones and reduces infection by infusing those grafts with a variety of antimicrobials.
“We know that it reduces infection,” said Shiels. “Other things to consider include adding a bulking agent … to help regenerate bone.”
Other research focuses on regrowing muscle lost in traumatic injuries, as well as recovering nerves, or at least preserving them, for future use. But besides treating those deep tissue wounds, there’s something a bit more on the surface that can impact warfighters: skin. The skin is known for its regenerative properties. Research is being conducted to help it do that job better and recover scar tissue.
Jason Brant with the University of Florida has turned to a mouse to help the military reduce scarring of injured warfighters. He said the African spiny mouse has evolved a capability to lose large parts of its skin when a predator tries to grab it, allowing the mouse to escape and live to recover. The mouse is able to recover scar-free in a relatively short amount of time, which is remarkable considering the amount and depth of tissue lost. Brant wants to know how the mouse is able to do that.
“Warfighters and civilians alike suffer large surface [cuts] and burns, and these result in medically and cosmetically problematic scars,” said Brant. “The impacts of these scars … are really staggering. The ability to develop effective therapies will have an enormous impact not only on the health care system but on the individuals as well.”
He believes a certain protein in the mouse could be the key, but he’s still trying to figure out how it could apply to humans.
Another way to reduce scarring involves the initial treating of wounds. Army Maj. Samuel Tahk, a research fellow with the Uniformed Services Health Consortium, passed around to attendees samples of biocompatible sponges he’s investigating for their ability to promote skin healing, and thus, reduce scarring.
“It provides a scaffold to start regenerative growth,” said Tahk. “This could simplify patient care and also reduce costs.”
While the field of regenerating body parts is still new, Saunders believes it will be the future of wounded warrior care.
“Extremity wounds are increasingly survivable due to the implementation of body armor and damage control surgeries,” he said. “[There are] many wonderful things emerging in the field of regenerative medicine to restore form and function to our wounded warfighters.”
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Knowledge Translation: What is it, How Will it Help?The Military Health System Research Symposium is Defense Department's premier scientific meeting.Researchers gather at the annual Military Health System Research Symposium (MHSRS) to share new discoveries from military-unique research. This event is the only meeting that focuses on the specific medical needs of the warfighter. One topic of discussion at this year’s symposium is knowledge translation.
On average, it takes over a decade before medical research is accepted and put into clinical practice at hospitals or clinics – too long a wait for those who need treatment. Knowledge translation can help speed that up. It’s basically a process to take medical research findings and put them into evidenced-based treatments in a more timely and useful way. A successful process is one that is standardized and adaptable.
Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) and Defense Health Agency are working together with other agencies to standardize knowledge translation processes for the Military Health System (MHS). The overall goal is to ensure service members and veterans continue to have access to the latest and best treatments available.
Before DCoE staff brought a model to MHS leaders, they extensively researched scientific best practices across the knowledge translation field. Then, they developed a process and tested it. The process they designed specifically for MHS consists of five steps:
- Needs and Gaps Assessment: What are the gaps in care that we need to bridge?
- Strategic Analysis: What are the possible solutions?
- Solution Material Development: What materials do we need to implement the solution?
- Dissemination: How can we foster support for this solution?
- Implementation: How do we integrate the solution to everyday practice?
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NMRC presents research on Recovery from Mild TBI following Uncomplicated mounted and dismounted IED Blast at MHSRSPhoto By Katherine Berland | Dr. Anna Tschiffely shared findings on the effects of mild traumatic brain injury (mTBI) on service members during the first 30 days following an improvised explosive device (IED) blast during the Military Health System Research Symposium (MHSRS) August 28 (U.S. Navy Photo/Katie Berland/Released)KISSIMMEE, Florida – A researcher from the Naval Medical Research Center (NMRC) shared findings on the effects of mild traumatic brain injury (mTBI) on service members during the first 30 days following an improvised explosive device (IED) blast.
“The purpose of this study was to utilize a natural history approach to describe and understand symptom recovery in injured military personnel diagnosed with a blast related mTBI,” said Dr. Anna Tschiffely, Research Psychologist, Neurotrauma Department, NMRC. The findings were presented during a poster session at the Military Health System Research Symposium (MHSRS), August 27 – 30.
Tschiffely, along with other NMRC researchers, focused on examining the first 30 days following injury in a cohort of service members injured by an IED related blast. The study focused on examining personnel injured in a dismounted (on foot) patrol vs. a mounted (in vehicle) patrol.
“Clinicians and patients alike may be interested in our findings to understand how the brain recovers following a blast exposure injury. The more we understand about what the days, weeks, and months following blast exposure look like in injured service members, the better we can treat them in the short-term and the long-term,” said Tschiffely.
Visual changes lasted three quarters of a day longer in service members injured during dismounted patrol. According to Tschiffely, it is important for clinicians to know military personnel injured during a dismounted patrol may have visual changes longer than personnel injured in a vehicle. This knowledge will help clinicians regarding the return to duty of service
members.
“While most service members returned to full-duty within 7-8 days, our findings indicate that headache is a common and persistent symptom. Service members who were involved in a dismounted patrol may report visual changes longer than service members injured during a mounted patrol,” said Tschiffely.
MHSRS is the Department of Defense's (DoD) premier scientific meeting; a unique collaborative opportunity for military medical care providers, DoD scientists, academia and industry to exchange information on research advancements and health care developments in the areas of combat casualty care, military operational medicine, clinical and rehabilitative medicine and military infectious disease research program.
NMRC’s eight laboratories are engaged in a broad spectrum of activity from basic science in the laboratory to field studies at sites in austere and remote areas of the world to operational environments. In support of the Navy, Marine Corps, and joint U.S. warfighters, researchers study infectious diseases; biological warfare detection and defense; combat casualty care; environmental health concerns; aerospace and undersea medicine; medical modeling, simulation and operational mission support; and epidemiology and behavioral sciences.
NMRC and the laboratories deliver high-value, high-impact research products to support and protect today's deployed warfighters. At the same time researchers are focused on the readiness and well-being of future forces.
Disclaimer: Re-published content may have been edited for length and clarity. Read original post.
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