Universal Limb Stasis System for Extended Storage (ULiSSES) for Soft Tissue Preservation Following Traumatic Amputation
Abstract
Combat and mass casualty situations, particularly where detonations have occurred, invariably result in a significant number of severed extremities and soft tissue trauma. In order to facilitate replantation, the extremity soft tissue needs to be preserved from deterioration, from several hours to several days, so that the patient can be transported to a medical facility and stabilized before replantation is attempted. Advances in microsurgical techniques and instrumentation have expedited the replantation of completely severed or amputated extremities. Unfortunately, the methods currently used to prevent the severed limb from deteriorating are only effective for no more than 12 hours. A significant volume of research has identified the value in circulating a cold, specifically formulated, oxygenated fluid through the severed limb so as to protect it from lack of oxygen and essential nutrients. Currently, there are no commercially available devices that can achieve this goal in a cost-effective manner. Technology developed at the University of Texas does not depend on pumps, motors, or electricity, but instead utilizes the energy stored in compressed gas (in this case, oxygen) to simultaneously oxygenate and circulate a preservation solution through a severed limb. Placing the device in an insulated container with cold packs reduces the limb’s need for oxygen and nutrients making it possible to extend the limb’s viability to several days as opposed to hours. This technology is simple and inexpensive. The proposed work will address the specific preservation requirements of skeletal muscle in order to calibrate the organ preservation technology to accommodate the unique size and metabolic requirements of individual extremity tissues. The resulting prototypes will be tested in a porcine model comparing contractile strength of the extremity before and after 24 hours of preservation. Additionally, chemical compounds in the limb tissues that define its health and metabolism will be measured during preservation. The structure of the tissues before and after preservation will also be evaluated microscopically. The expected results of this work will be an inexpensive, highly portable device into which a severed extremity could be placed so that it would remain healthy until the patient is ready for reattachment. Also, for patients in need of a limb for transplantation, this device will maintain the health of donor extremities during transport from the donor hospital to the transplant hospital. Most importantly, this technology will eliminate geographical limitations from which donor extremities can be obtained. Post traumatic stress disorder and depression are significant consequences of traumatic amputations. The lifetime costs for caring for amputees exceeds $600 billion. This technology significantly increases the probability of limb recovery, preservation, resuscitation, and, ultimately, successful replantation thereby alleviating personal suffering and reducing healthcare costs for injured troops. This technology will also have a significant impact in the civilian sector, as traumatic amputation, 700,000 per year, is the second leading cause of limb loss in the United States. The immediate impact of implementing the technology developed under this proposal will be the facilitated forward care of traumatically amputated limbs and the potential for stabilization, preservation, and resuscitation of those limbs for 24 hours or longer. The long-term impact will be shortened post re-plant recovery, improved limb function, and reduced physiologic and psychologic sequelae following replantation. Extending limb and tissue preservation time will facilitate resuscitation research, developing methods for reviving limbs and tissues thought to be no longer viable. It will provide a platform for pharmacological treatment and potentially in-vitro tissue regeneration research. Advances to this technology could open the possibilit
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810640
Entities
People
- Leonid Bunegin
Organizations
- United States Army
- University of Texas Health Science Center at San Antonio