The Wearable Extremity Injury Stabilization System (ExISS) for Prolonged Field Care and Prehospital Limb Care
Abstract
Objectives and Rationale: Severe traumatic musculoskeletal injuries are extremely common on the battlefield and in non-combat scenarios. Acute trauma overwhelms the regenerative capacity of tissues: consequently, injured tissues do not regenerate and heal by irreversible fibrosis. This problem applies to 65% of all battlefield wounds and approximately 68,000 military members and 500,000 civilians every single year. These individuals face chronic disability and/or a long and challenging path of rehabilitation that only occasionally leads to full recovery of initial muscle strength and function. Considering that musculoskeletal injuries occur relatively early in adulthood, the life-long burden of disability in the military population is deeply concerning. Today, these complications can be prevented, minimized, or even avoided by developing new strategies for early limb trauma care. Tissue cooling has shown the capacity to slow down death of injured tissues and halt fibrosis. This principle is used for the preservation of transplanted organs during transportation and amputated body parts before replantation. Surprisingly, it is not used for preserving limbs after traumatic injury. This project will define the effects of tissue cooling in limb musculoskeletal trauma to develop novel treatments for military and civilian patients. We will use a portable cooling device to prevent or mitigate limb damage during pre-hospital care. This early intervention will optimize treatment and positively affect overall trauma care. We aim to develop a simple and effective limb-saving and function-saving strategy. Applicability: Musculoskeletal limb injury is extremely common in the military and in civilians (motor vehicle accidents, workplace injuries, and mass casualties). Trauma care for these patients does not end with the treatment of acute life-threatening injuries, but rather continues through a long path of rehabilitation. Functional disability after injury relates to the inability of muscles to effectively regenerate. Instead, muscle injuries heal by scarring and fibrosis, leading to long-term loss of strength and enduring disability. The increased number of wounded Warriors over the last decade of military conflicts has exposed the need for novel treatments that prevent or limit negative healing phenomena immediately after injury, allowing tissues to recover and promoting repair and regeneration. Our approach aims to challenge existing gaps and limits in trauma care and improve best practice for the direct benefit of military and civilian patients. Relevance to the FY20 PRORP ARA Focus Areas: This preclinical applied research aims to develop a new strategy to provide field/en route effective treatment to military and civilian patients with musculoskeletal injuries. We address the Focus Area, “Limb Stabilization and Protection: Development of rapid limb stabilization and novel wound protectants for severely wounded limbs to enable transport at the point of need.” Impact: Today, no strategy is available to control injury in limbs and mitigate their damage from initial trauma until final care at a medical facility. Considering that musculoskeletal injuries occur relatively early in adulthood, the life-long burden of disability in the military population is concerning. Lifetime disability cost can reach $440,000 per patient; related healthcare costs exceed $700 million a year just for the Department of Defense (DoD). Civilian affected by musculoskeletal injuries return to work only in ~50% of cases. The societal and economic impact of these injuries is over $30 billion/year in direct costs and at $400 billion/year in associated medical costs and loss of productivity. These numbers emphasize the urgent need for effective injury-mitigating solutions. Potential Clinical Applications, Benefits, and Risks: The treatments and devices established by this project will be broadly applicable to traumatized lim
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110836
Entities
People
- Giorgio Giatsidis
Organizations
- United States Army
- University of Massachusetts Medical School