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Battlefield trauma techniques may help civilians

SAN DIEGO (Reuters) - Advances in treatment of horrific battlefield injuries in Iraq and Afghanistan that have saved the lives of many U.S. soldiers who would have died in previous wars may yield valuable techniques for treating civilian trauma victims, military doctors said.

Survival rates have improved to 90 percent in this war from about 75 percent during the Vietnam War, even though today's weapons are more lethal.

"People are surviving more mutilating injuries," Dr. Dana Covey, a Navy captain and chairman of the Department of Orthopedic Surgery at the San Diego Naval Medical Center, said in an interview.

According to the U.S. government, nearly 24,000 soldiers have been injured in the conflict so far. Critics argue that the estimate doubles when military accidents sustained away from combat, brain injuries that can turn up later or other diseases like pneumonia are included.

Covey, who has spent a total of 10 months in Iraq, said better armor has resulted in fewer injuries to the torso, and more injuries to the extremities, especially the arms.

Despite the improved armor, throughout the Iraq war the U.S. military has struggled to maintain sufficient armor to protect its troops, including armored vehicles and personal armor.

Doctors said new techniques and the practice of saving skin, muscles and injured tissue have reduced the number of amputations.

"What we're learning about and getting a lot better at is saving limbs," said Dr. Arnold Scheller, a Boston-based surgeon who served as an emergency doctor in Iraq and Afghanistan.

"We're doing vascular and nerve repairs and we're salvaging limbs when we wouldn't have before. We would have amputated," he said.


These techniques, he added, can be applied to civilian blast injuries and high-speed motor accidents.

There already have been dramatic improvements in prosthetics using lighter-weight material for comfort and microprocessors for better function.

"Prosthetics was a sleepy specialty that has turned into an exciting area and this war has been a stimulus to that," Dr. Michael Mazurek, a Navy commander from the San Diego Naval Medical Center, said.

Battlefield traumas in Vietnam yielded medical advances such as the development of trauma centers that employed a concentration of specialists.

Applying wartime medical techniques and technology to civilian care happens in every conflict, said Commander Michael Mazurek M.D. "That history is still being written."

Increasingly, academia and the industry are working with the military more closely to fulfill needs of the injured.

Covey said he began working closely with a small company called SurModics Inc. a year ago after he met executives at the annual orthopedics meeting last year in Chicago. SurModics makes coatings for cardiac stents.

"It was very fortuitous because it's not even an orthopedics company," Covey said.

"I was just there at the meeting at a hot dog stand and I was in uniform. One of the corporate reps stopped by and said hi and told me that he had been in the Navy and they started asking me what we need," Covey recalled.

Covey asked if SurModics could make beads, strung like a pearl necklace, coated with one or more types of time-released antibiotics.

"I had just returned from Iraq and I thought it would be nice if I had something I could put in a wound before I shipped them off to the helicopter," Covey said.

SurModics Chief Financial Officer Phil Ankeny said the antibiotic beads are in the late stages of development. He declined to say when it expected to file an approval application to the U.S. Food and Drug Administration.

"As unfortunate as war is, many medical advances are made during war time," Covey said.

(Additional reporting by Kim Dixon)

Reuters Health