Combat Injuries Spur Medical Innovations

Article excerpt

Two years ago in Baghdad, Iraq, l.TC Greg Gadson, commander of 2nd Battalion, 32nd Field Artillery, 1st Infantry Division, lost Both of his legs above the knee when his convox was lui by a roadside bomb. In April, LTC Gadson became the first person in the world to receive the most technically advanced mechanical legs, whuh feature battery-powered knees. Mis new prosthesis, the Power Knee2, is lighter, quieter, smaller and more powerful than the origina Power Knee, which was introduced three years ago. Sensors and artificial intelligence in the knee not only react to movement, but also anticipate it; the prosthesis, in effect, "learns." Instead of simplx offering resistance se the user can walk, the electronic knee helps propel him, reducing the extra workload of walking with prostheses. Mie improvements to the Power Knee and other prosthetic devices were based on feedback from LTC Gadson and other amputees ,it Walter Reed ArmsMedical Center (WR WlCc Washington, D.C.

The current wars m Iraq and Afghanistan have encouraged rest-arch and development in the prosthetics industry. Historically, war has pushed medical innovations and sped technoloalready in development. I he use of tourniquets and amputation to save lives dates back to Roman times. During the Spanish Amene, in War, fewer than 400 U.S. soldiers were killed in combat while more than 2,000 contracted yellow lexer, spurring MAJ Walter Reed and other medical professionals to confirm that the disease is earned by mosquitoes. Blood transfusions were performed on the batik-field during World War I, and World War 11 accelerated the development of mass-produced penicillin. Helicopter trauma transport began during the Korean War. Aiding combat casualties has led to advances in technologies and treatments that later benefit the civilian population.

While treating blood loss in battlefield casualties in Iraq and .Afghanistan, medics and doctors have learned several ways to raise survival rates, among them increasing the ratio of red blood cells to plasma in transfusions and creating a tourniquet that can be applied with one hand. The Asherman Chest Seal, a bandage and oneway valve that allows the air «nil of a punctured lung, is another lifesaver, as is ? ombal Gauze, which uses a tine cla) to help staunch bleeding. Surgeons have also found that in head trauma conditions, removing a section of skull, evei when no shrapnel is in the wound, relieves pressure that might otherwise render a patient brain-dead.

Better preparation and equipment have contributed to saving lives. Medics are better trained than before; every soldier is trained and equipped as a combat lifesaver and carries an up-to-date first-aid kit. Body armor, helmets and mine resistant ambush protected vehicles help shield soldiers from bomb blasts. Gear and safety precautions combined with improvements in trauma treatment have resulted in a better survival rate: 90 percent of those wounded in Iraq and Afghanistan come back alive, according to the U.S. Army Medical Department, the highest percentage of any war. (During World War II, the figure was 60 percent.)

Many soldiers who would have bled to death from the loss of a limb or died from head or torso wounds now survive. Blast-injury victims like LTC Gadson are surviving in record numbers. According to a 2004 Senate report, amputees made up about 3 percent of the wounded in previous wars, compared to 6 percent of those injured in Iraq.

As of April 1, more than 870 amputee servicemembers wounded in Iraq and Afghanistan have been treated in military facilities; 665 of them were soldiers. That figure is a small percentage of the total number of amputees in the United States, most of whom are dia- betic or beyond middle age. Military amputees are younger, healthier, fitter and more active than most other am- putees. "The wear and tear exerted on lower limbs by civilians is different from that exerted by servicemembers," LTC (Dr.) Paul F. …