Scope of Research
Advances in trauma care on the modern battlefield,
along with improvements in personal protective
equipment, have decreased the case fatality rate by 50%
in comparison to that in the Vietnam War (Holcomb et
al., J.Trauma, 2006). Much of this improvement has been
attributed to better trauma systems design, application
of the principles of damage control surgery, better
management of the coagulopathy of trauma, and
application of modern intensive care close to the point
of wounding. However, developments in the understanding
of critical illness, traumatic brain injury,
haemorrhage control and the design of trauma systems,
amongst others, promise even further improvements.
Priority areas for research performed by or undertaken
in collaboration with the Defence Chair of Military
Surgery and Medicine include:
-
Fluid resuscitation in trauma, including
effectiveness of frozen red cells and platelets in
trauma resuscitation, the modulation of
trauma-induced coagulopathy and inflammation, novel
methods of preserving and delivering blood clotting
factors, and developments in circulatory access
devices;
-
Acute cognitive impairment, including
characterisation and initial treatment of mild and
severe traumatic brain injury and critical illness
delirium;
-
Traumatic lung injury, including
pharmacological and ventilator management of lung
injury sustained in blunt or blast trauma;
-
Sepsis in trauma, including early diagnosis of
sepsis and identification of infecting organisms
using molecular diagnostics and investigation of
methods to reduce bacterial translocation across the
bowel wall;
-
Design of trauma systems, investigating the
effectiveness of initial damage control surgery in
smaller hospitals compared with longer transport
times to major trauma centres, the effect of team
training on efficiency and safety, and the utility of
telemedicine for clinical management and governance.
Projects in each of these areas are, or will be,
performed in collaboration with civilian institutions and
are expected to benefit to both civilian and military
trauma patients. As such, the research programme will be
funded largely by competitive extramural grants by
2014-2016.
7 December, 2011
