"Optimizing Combat Casualty Care"
Nicole Caldwell was awarded the 'Best in Category' award for her poster at the American Burn Association Annual Meeting. Photo by Steven Galvan

Nicole Caldwell was awarded the "Best in Category" award for her poster at the American Burn Association Annual Meeting. Photo by Steven Galvan

USAISR Burn Center staff integral members of ABA

By Steven Galvan, Public Affairs Officer
U.S. Army Institute of Surgical Research
1 MAY 2014

The American Burn Association (ABA) held its 46th Annual Meeting in Boston March 25-28 with 19 staff members from the U.S. Army Institute of Surgical Research Burn Center (USAISR) in attendance. The ABA is committed to advancing burn-related research, education, treatment, rehabilitation, and prevention to improve the lives of those affected by burn injuries. The annual meeting is designed to provide the optimal occasion to increase knowledge to its members and guests on the state-of-the-art scientific and practice advances in burn care.

Even though the number of attendees from the USAISR was minimal, the presence of the Institute was evident throughout the four-day event. Several members presented or moderated plenary and poster presentations (including 4 of 8 Nursing Correlative Sessions), two members were presented major awards, and an appointment to chair a national committee.

“I am very pleased and proud with our performance and contributions to the ABA meeting,” said Col. (Dr.) Booker T. King, USAISR Burn Center Director. “It all speaks highly of the people here [burn center] and the work that we’ve submitted.”

The two awardees for their research were: Clinical Research Coordinator, Reginald “Reg” L. Richard, who received the “Best Paper” award, and Nicole Caldwell who earned the “Best in Category” award for posters. Lt. Col. Elizabeth Mann-Salinas was appointed to Chair the Committee on Technology—keeping the number at 8 USAISR personnel on ABA national committees.


The “Burke/Yannas Bioengineering Best Paper Award” was presented to Reg Richard for his manuscript titled: “Hierarchical Decomposition of Burn Body Diagram Based on Cutaneous Functional Units and Its Utility.”

“It’s on a DoD funded study that takes a standard burn body diagram used to document burns and burn severity,” said Richard. “The existing diagram is modified to be more specific for burn rehab and improving patient outcome.”

Richard compared the hierarchical decomposition system for mapping burns and estimating the total body surface area burned to the structure of the U.S. postal zip code structure. In a zip code, the first number represents a geographical area, the next two numbers identify the regional area, and the last two numbers represent the specific post office.

“It [hierarchical decomposition] breaks it down to smaller subcomponents which helps us [physical therapists] determine the type of rehab needed to the area of the body that is burned,” he said. Richard mentioned that the current burn and degree of burn mapping system that is currently being used in burn centers has not changed in more than 70 years. The current template has the palm of the hand as one segment and the hierarchical decomposition te

mplate has 29 separate areas in the same segment as the standard one.

“This allows us to concentrate on doing more rehab to specific areas which can minimize scar contracture,” said Richard. “Burn wound begin to heal itself right after the burn process stops. If we know where to concentrate the rehab then the outcome will be better.”

Richard said that he was proud to have this position in research and conduct the type of work that he does.

“It’s an honor to do this type of research,” he said. “This is the only position in the U.S. that allows a physical therapist to do research and I am fortunate to be at the ISR doing it.”

Additionally, an abstract by Richard titled “Increased Burn Rehabilitation Treatment Time Improves Patient Outcome” was selected as one of the Top 6 Abstracts during the meeting.


Nicole Caldwell was awarded the “Best in Category” award for her poster titled “Pathogenic Bacteria on Common Access and Identification Cards: A Search for Badge Bugs.”

“Since the Department of Defense implemented new security requirements that we must all use a CAC [common access card] to access a government computer, we decided to do a study to see what types of bacteria were found on them,” said Caldwell. “Everyone also carries an ID badge to access our work areas in the Burn Center.”

Caldwell said that patients in the Burn Intensive Care Unit (BICU) are at a higher risk for infection and while certain measures are taken for infection control there’s no policy for cleansing IDs and CACs.

“We swiped more than 100 CAC and ID cards from employees at the BICU and from the staff at the outpatient burn clinic,” she said. “A small percent of the cards had been cleaned during the week that we collected the specimens.”

According to Caldwell, there were no significant differences in the bacteria counts between the BICU and outpatient clinic cards, but the rate of bacteria was significantly lower on the cards that had been cleaned in the last week.

“This study shows that if we clean our cards at least weekly we can have a positive effect on contamination rates,” she said.

Caldwell got the idea for this study from her supervisor Lt. Col. Elizabeth Mann-Salinas, USAISR Systems of Care for Complex Patients Task Area Manager.

“She is totally amazing and deserves every bit of recognition there is,” said Mann-Salinas. “I could not be more proud of her initiative, academic skill, and professionalism.”


Lt. Col Elizabeth Mann-Salinas was selected to chair the ABA Committee on Technology which provides a forum for the ABA to adopt new technologies. This is the second year since this committee was formed and Mann-Salinas was the co-chair the year it was created. She said that being named chair is a big honor and can envision her role in the committee.

“My vision is to create an ABA app that can be used for training, guiding patient care, and family patient care,” she said.

Mann-Salinas also stated that it is important for members of the Institute to chair or be members of the various ABA committees.

“It is a great platform to get our innovations out to the burn care and research community,” said Mann-Salinas.

The Committee on Technology will be the perfect forum to introduce products designed at the USAISR to the ABA like the Burn Resuscitation Decision Support System-Mobile (BRDSS-M, also known as the Burn Navigator, and the burn patient mapping program WoundFLow. The BRDSS-M is designed specifically for providers who routinely do not care for burn patients with recommendations on life-saving resuscitative fluids during the initial 48 hours after injury. The WoundFlow is an electronic burn mapping system used for documenting burns and ongoing surgical treatments.

“It is important that we present our work to burn care providers,” said Mann-Salinas. “We have to share and show what the Army and ISR are innovating.”