JBSA-FORT SAM HOUSTON –
Imagine a Soldier suffered debilitating burns to 60 percent of his body while deployed. After being evacuated to a burn treatment facility and stabilized, surgeons treated his wounds using a biopsy of his own skin, and re-grew tissue over the injuries.
There was little risk of infection, as the wounds were covered quickly, and surgeons did not have to create additional wounds by harvesting large quantities of skin from his body. The Soldier's body does not reject the new skin, as it was generated from his own cells. He is able to make a full recovery.
This is the future of burn care, according to experts at the U.S. Army Institute of Surgical Research Burn Center at Joint Base San Antonio-Fort Sam Houston. The primary mission of the center is to evacuate and treat combat causalities with thermal injuries, ex-plained director Col. (Dr.) Booker T. King.
"We have a multi-disciplinary staff, including surgeons ... nurses of ... both critical care as well as ... normal bedside -- rehabilitation, re¬storative therapy, you name it. We also have a burn flight team. ... the burn flight team's job is to evacuate severely injured burn casualties, mostly military-related combat, from wherever we can pick them up to back here in San Antonio," King said. The burn flight team's proper name is Special MEDCOM Response Capabilities/Burn.
The center performs wound evaluation, physical and occupational therapy, patient education and is continuing to develop a psychoso¬cial care program, King said. In addition to surgical burn treatment and rehabilitation, the center is participating in several clinical trials to advance skin treatments.
"We're currently a part of two major regenerative multi-center trials," King said. "And they are sponsored in part by the Depart-ment of Defense. Another group is also involved, they're called AFRIM, Armed Forces Institute of Regenerative Medicine -- that's a partnership between the Department of Defense and civilian enti¬ties."
The two U.S. Food and Drug Administration trials the USAISR is participating in are the ReCell and StrataGraft trials.
The ReCell trial takes a piece of skin the size of a stamp and uses it to create a solution of individual cells to cover a wound. The StrataGraft trial grows bioengineered skin from stem cell technol¬ogy, King explained, adding that these skin substitutes are the "holy grail" of burn surgery.
"The StrataGraft project is the most exciting thing we've been a part of; it was a phase-two trial, sort of a pilot study to design the definitive phase three, and it is an off-the-shelf skin substitute that has lots of promise in helping revolutionize burn care," said Lt. Col. (Dr.) Kevin Chung, task area manager of clinical trials in burns and trauma.
"One of the biggest challenges with taking care of burns is getting them to have the burns taken off in a timely fashion, and then hav¬ing that previously burned skin be covered with what we call defini¬tive coverage. And the only thing that provides definitive coverage and allows patients to heal and get on their way to recovery is their own skin, at the moment," he added.
For example, if a patient with 40 to 50 percent of their skin burned goes into surgery, all their normal areas of skin will be har-vested to cover the wound in an autograft.