Regenerative Medicine Applications in Combat Casualty Care

Abstract

The purpose of this report is to describe regenerative medicine applications in the management of complex injuries sustained by service members injured in support of the wars in Afghanistan and Iraq. Improvements in body armor, resuscitative techniques and faster transport have translated into increased patient survivability and more complex wounds. Combat-related blast injuries have resulted in multiple extremity injuries, significant tissue loss and amputations. Due to the limited availability and morbidity associated with autologous tissue donor sites, the introduction of regenerative medicine has been critical in managing war extremity injuries with composite massive tissue loss. Through case reports and clinical images, this report reviews the application of regenerative medicine modalities employed to manage combat-related injuries. It illustrates that the novel use of hybrid reconstructions combining traditional and regenerative medicine approaches are an effective tool in managing wounds. Lessons learned can be adapted to civilian care.

Keywords::

• amputation
• combat casualty care
• extremity reconstruction
• limb salvage
• regenerative medicine

Acknowledgements

The authors thank Nancy Lee (Walter Reed National Military Medical Center Department of Orthopaedics Research Coordinator) for her expertise and support in the editing of this manuscript.

Disclaimer

The views expressed in this article are those of the authors and do not reflect the official policy of the Department of Defense, or US Government.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Informed consent disclosure

Written informed consent has been obtained from the participants involved in the study. Appropriate Institutional Review Board clearance obtained.