In 2010, the Rutgers-Cleveland Clinic Consortium will begin clinical trials of therapies for three of the most difficult challenges military medicine faces in the care of severely injured warriors.
Skin and joints contracted due to extensive scarring
Adam Katz, MD, of the University of Virginia, will use and modify established plastic surgery procedures to explore procedures to accelerate the healing and remodeling of severe existing scars.
Improvement of extensive scarring trial (currently enrolling)
Significant damage and deformity can be caused by scars over large areas of the body. Such extensive scars are usually made by burns. RCCC is exploring a new surgical procedure involving transfer of fat from the patient in order to reduce damage caused by scarring. This fat transfer procedure has been performed on thousands of patients receiving ‘cosmetic’ surgery. However, these outpatient procedures were never given a serious scientific review. This clinical trial will scientifically test the potential and limitations of fat tissue transfer to speed healing and re-shape existing scars.
Extensive and deep injuries to the face
Composite tissue grafts from donor patients for facial reconstruction under Maria Siemionow, MD, PhD and her team of surgeons at the Cleveland Clinic, in coordination with the US Army Institute of Surgical Research.
Face transplant trial
In 2008, Dr. Maria Siemionow performed the first successful face transplant in the United States. This operation restored function to a civilian woman who lost her nose, entire upper jaw and mid face in a shotgun injury. The entire mid face from a donor who had died was transplanted. This work is, at this time, the most technically complex procedure yet done anywhere in the world. During the next year, Dr. Siemionow and her team will continue to develop this therapy that could benefit a large number of warriors who have suffered major trauma to the face, have had upper limb amputations, or combination injuries to face and limb. The loss of the face is a horrible injury, making the injured warrior feel especially bad about himself or herself and creating huge obstacles to returning to civilian life.
Life-threatening, 3rd degree burns to more than 50% of the total body surface area
Engineered human skin formed from skin taken from another part of the patient. One of AFIRM's industrial partners, Steven Boyce, PhD of the University of Cincinnati, and surgeons at the US Army Institute of Surgical Research and the Brooke Army Medical Center in San Antonio collaborate to provide an autologous (formed from skin donated by the patient) skin device to patients with full-thickness burns of greater than 50% of the total body surface area.
Extensive, life threatening burns trial
Because acute and long-term clinical management of severely burned warriors is among the most difficult and most expensive challenges of the military health care system, RCCC made the development of an engineered skin substitute as one of its high-priority goals. This substitute is ‘autologous’, meaning it uses the warrior’s own skin. Based on the work of Dr. Steven Boyce, a small section of healthy skin can be expanded significantly in a tissue culture laboratory. At the end of three weeks, there will be enough skin to cover large body surface burns. Unlike skin grafts from donors, RCCC's skin substitute consists of the patient's own cells, does not cause an immune reaction, and is fully reintegrated into the patient's body. This eliminates the need for extensive and repeated skin grafting. The autologous skin device will become available to treat patients with full-thickness burns of greater than 50% of the total body surface area. This technology will save the lives of the most severely burned warriors, and it can improve their overall appearance, while shortening their stay in an intensive care unit.
For more information on clinical trials contact us here. 
