Light-Activated Sealing to Improve Outcomes Following Penetrating Bowel Trauma
Abstract
Penetrating colon injury occurs in around 5% of all military trauma in current conflicts. A penetrating injury, such as a puncture or a complete severance, is a highly dangerous injury as the waste materials in the colon contain high levels of bacteria that can leak into the abdominal cavity and induce a series of events that can lead to infection, inflammation, sepsis, and shock, and, if unchecked, will be lethal to the patient. Penetrating injuries will generally be closed by one of various suture approaches, but even in the best civilian trauma centers, with top-end surgeons and equipment, there is a 1%-3% rate of failure that can lead to considerable complications, morbidity, and even mortality. However, this rate is far higher (~20%-30%) in wounded Warfighters for a number of reasons. The patient will generally have other extensive injuries, especially those associated with hemorrhage and excessive blood loss, that impact on the physiological status of the patient during and after surgery. In addition, the wound is likely to be "dirty" with respect to elective surgery wounds with contamination leading to infection-related complications. The background, expertise, and experience of the military surgeons performing the repair are typically more diverse than the specialist in a civilian trauma center and the resources available to the military surgeon will also be limited with respect to the civilian environment. In order to close this gap and improve outcomes of wounded Warfighters that suffer penetrating bowel injury, we have developed a light-activated method for bowel wound closure that produces a stronger wound closure, involves considerably less specialized technical skill, and is faster than current suture closure techniques. Wound surfaces are painted with a red dye and placed in close contact. Green light illumination causes chemical reactions to occur at the wound surfaces that form innumerable chemical bonds that hold the wound securely closed in a water-tight, leak-free fashion. In this proposal, we aim to optimize the procedure and the materials used for clinical efficacy in a military-relevant wound model and validate its potential for rapid adoption for use in humans, with particular emphasis on improving outcomes for wounded Warfighters. It should also be noted that the same technology is equally applicable for bowel repair in civilian medicine, including trauma surgery and rejoining the bowel after removal of diseased tissue such as cancer.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Aug 07, 2017
- Source ID
- W81XWH1710388
Entities
People
- John Parrish
Organizations
- Massachusetts General Hospital
- United States Army