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Wound Infection Research

Program Overview:
The multi-national forces serving in the current conflicts in Iraq and Afghanistan are faced with a continued threat related to Improvised Explosive Devices (IEDs), mortars, rocket-propelled grenades in addition to gunshots. Over 18,000 members of the U.S. military have been wounded in action while serving in Iraq or Afghanistan, and 15,166 did not return to duty (US casualty status, Washington, D.C. Department of Defense). Approximately 20% of injured soldiers have had multiple injuries. Improved body armor as well as new medical treatment approaches to save limbs and keep patients alive has increased the number of surviving Warfighters being treated for severe limb wounds due to blasts. The wounds resulting from OIF/OEF war injuries frequently involve traumatic amputations, large soft-tissue defects, skeletal trauma with exposed bone, and burns. Environmental contamination often occurs at the time of wounding. More importantly immune overshoot and dysregulation in response to life threatening trauma and massive transfusion (equivalent to one or more complete exchange transfusions) result in a host with impaired immune response who is highly susceptible to nosocomial infection. Approximately 5% of casualties in OIF/OEF have had burns. There were 1,258 patients admitted to the Brooke Army Medical Center burn center from January 2003 to May 2006. Out of these, 129 patients became bacteremic during hospitalization. Bacteremia is associated with increased mortality and increased number of days on a ventilator. Patients with burns may require treatment with higher doses of antimicrobials because of impaired pharmacokinetics. The most common bacteremia pathogens were Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter calcoaceticus-baumannii complex, and Staphylococcus aureus. Research in Program Area W is focuses on the development and evaluation of technologies and therapies to prevent and treat infections in combat casualty injuries.

Diarrhea Prevention | Rickettsial Disease | Wound Infection Research