U.S. ARMY INSTITUTE OF SURGICAL RESEARCH
"Optimizing Combat Casualty Care"

Extremity Trauma & Regenerative Medicine


RESEARCH FOCUS

Extremity injuries are the most commonly injured part of the body and account for approximately two-thirds of the initial hospital costs, rehospitalizations, and reasons for medical retirement from active duty. Our research effort focuses on optimizing the outcomes of extremity injuries and burn. We achieve this by conducting research designed to reduce initial injury complications and use advanced regenerative medicine technologies to replace missing tissue such as bone, muscle, and skin.


RESEARCH GOALS

  • To return Wounded Warriors to full function after extremity injury and burn
  • Define the clinical problems and barriers of Wounded Warriors from retrospective studies and trauma registries
  • Provide critical information for developing Clinical Practice Guidelines
  • Develop regenerative solutions for missing skin and musculoskeletal tissue
  • Conduct prospective clinical trials to determine best practice

CORE COMPETENCIES

  • Extremity Trauma
  • Regenerative Medicine
  • Clinical Trials

CURRENT PRECLINICAL RESEARCH EFFORTS

  • Develop a biofilm dispersive graft that promotes bone healing while reducing infection
  • Improve outcomes of volumetric muscle loss injuries by reducing fibrosis and regenerating missing skeletal muscle using tissue engineering and regenerative medicine approaches including: autologous minced muscle grafts, biological scaffolds, stem cells, and microvascular fragments
  • Develop readily-available vascularized full thickness skin graft
  • Elucidate mechanisms that cause deleterious effects on healing associated with polytrauma and open fractures

CURRENT CLINICAL RESEARCH EFFORTS

  • Define the clinical issues to help develop research gap areas
  • Determine impact of Return-to-Run Clinical Pathway on return to duty rates of those with severely injury lower extremities
  • Participate and contribute patients in multi-center clinical trials (www.metrc.org)

Contact the ETRM Research Director, click here.


RECENT PUBLICATIONS

Natesan S1, NL Wrice, DG Baer, RJ Christ. Debrided skin as a source of autologous stem cells for wound repair. Stem Cells. 2011 Aug;29(8):1219-30.

Zamora DO, S Natesan, S Becerra, N Wrice, E Chung, LJ Suggs, RJ Christy. Enhanced wound vascularization using a dsASCs seeded FPEG scaffold. Angiogenesis. 2013 Oct;16(4):745-57.

Corona BT, K Garg, CL Ward, JS McDaniel, TJ Walters, CR Rathbone. Autologous minced muscle grafts: a tissue engineering therapy for the volumetric loss of skeletal muscle. Am J Physiol Cell Physiol. 2013 Oct 1;305(7):C761-75.

Corona BT, X Wu, CL Ward, JS McDaniel, CR Rathbone, TJ Walters. The promotion of a functional fibrosis in skeletal muscle with volumetric muscle loss injury following the transplantation of muscle-ECM. Biomaterials. 2013 Apr;34(13):3324-35.

Sanchez CJ, EM Prieto, CA Kruger, KJ Zienkiewicz, DR Romano, CL Ward, KS Akers, SA Guelcher and JC Wenke. Effects of Local Delivery of D-Amino Acids from Biofilm-Dispersive Scaffolds on Infection in Contaminated Rat Segmental Defects. Biomaterials. 2013 Oct;34(30):7533-43.

Sanchez CJ Jr., KK Mende, ML Beckius, KS Akers, DR Romano, JC Wenke, CK Murray. Biofilm Formation by Clinical Isolates from Patients Receiving Treatment at a Military Medical Facility. BMC Infect Dis. 2013 Jan 29;13:47.

Ficke JR, WT Obremskey, RJ Gaines, PF Pasquina, MJ Bosse, CN Mamczak, RV O’Toole, KR Archer, CT Born, ME Fleming, JT Watson, WT Gordon, JP Stannard, DM Rispoli, EJ MacKenzie, JC Wenke, JR Hsu, AN Pollak, RC Andersen. Reprioritization of Research for Combat Casualty Care. J Am Acad Orthop Surg 2012; 20(suppl 1):S99-S102.

Cross JD, JR Ficke, JR Hsu, BD Masini, JC Wenke. Battlefield orthopaedic injuries cause the majority of long-term disabilities. J Am Acad Orthop Surgeons. 2011;19 Suppl 1:S1-S7.

Cross JD, DJ Stinner, TC Burns, JC Wenke, JR Hsu, STReC. Return to Duty Following Type III Open Tibia Fracture. J Orthop Trauma. 2012 Jan;26(1):43-7.