Military Medicine Advances Burn Injury Treatment

Of the many military medical advances that have resulted during the wars in Iraq and Afghanistan, one breakthrough has been in the treatments for burn patients, according to military and civilian medical experts attending a Defense Department-sponsored conference held in Fort Lauderdale, Fla.

At the Military Health System Research Symposium yesterday, a panel of physicians discussed with reporters the latest research and clinical trials that are advancing the treatment of burn patients in the segment, “Breakthrough Science: Opportunities in Regenerative Medicine.”

Though the war in Afghanistan is winding down, burn treatment research continues, the physicians said.

The implementation of added fire-safety procedures and new treatments for burn patients began in 2008 when there were many burn casualties from improvised explosive devices and other war-related incidents, said Army Col. John Scherer, director of the Clinical and Rehabilitative Medicine Program at the U.S. Army Medical Research and Materiel Command at Fort Detrick, Md.

“We put a lot of emphasis in that area. We’ve done a lot with burn surgical care and made a lot of improvements in clinical trials,” Scherer said.

About 100 severely burned service members per year were treated at the peak of the Iraq and Afghanistan wars, he said.

“We’ve seen that [number] come down dramatically,” Scherer said, “due to some excellent work at protecting our soldiers, sailors, airmen and Marines from burn injuries — the vehicles that protect them, clothing that’s burn-resistant and fire-suppression systems in vehicles.”

And, medical advances made within the last decade are assisting physicians who treat today’s burn patients, said Dr. James Holmes IV, director of the Wake Forest University Baptist Medical Center’s Burn Center, and associate professor of surgery at the Wake Forest University School of Medicine.

“We’re literally are on the verge of having a new day-to-day world of burn surgery, where we’re able to do things for patients that many older burn surgeons at the end of their careers only dreamed about,” Holmes said. “That has only happened in the last five to 10 years. Before that, the advancements were stagnant.”

The new technologies now in clinical trials — thanks to DOD funding — are “incredibly practice-altering,” he said.

“It’s a direct result of the support from the DOD and the military,” Holmes said. “We have to keep the commitment coming to deliver the technologies, products and therapies to wounded warfighters and civilians in a timely, persistent manner.”

Some of the advancements include replacing burned skin with new-grown skin, said Dr. David Baer, director of research at the U.S. Army Institute of Surgical Research.

“We’ve … come up with ways to engineer and grow skin that can be collected from a small patch [of] skin, process it and grow it in the lab and return it to the patient,” Baer said.

That technique and a new “spray-on” skin process, he said, are now in clinical trials.

“The early results are excellent,” Baer said. “We’re waiting for final results and we’re looking forward to getting those FDA-approved.”

Military medical research also has shown that a burn patient’s fluid balance is delicate and must be managed in a prescribed manner, particularly during the first few days following the burn incident, Baer said. A computer program that can be used in the field has been devised to accurately measure a patient’s fluid intake, he added.

Treatments for burn-caused scarring and other traumatic injuries have advanced, too, the physicians said. They now are researching how scars are formed, and how the scarring process can be slowed and even remodeled.

Medical research efforts also are focused on advancing reconstructive surgery and scar modification techniques for burn injuries, Scherer said.

“There’s going to continue to be human conflict and with that there will come burn injuries,” Holmes said. “We’ve got to advance what we do. It’s through a very transparent, collaborative partnership with the military, DOD and the civilian burn community [that] we’re able to do this.”

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