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Research

The Trauma Burn Center is a national leader in research advancement. A central philosophy of the center is to develop and disperse new knowledge regarding trauma and burn care. Members of the TBE team (doctors, nurses, social workers, respiratory care therapists, physical therapists, etc.) are actively involved in a wide range of multi-disciplinary clinical research. Clinical research focuses on improving patient care, evaluating current treatment practices, utilizing new products and drugs, developing less invasive and more efficient methods of diagnosing injuries, preventing injury-related complications, developing new technologies, enhancing quality of life, and may also identify methods to help reduce health care costs. Results of clinical research are used as the basis for changes in treatment practices that improve patient care and outcome. Our clinicians disseminate their findings to other health care personnel across the country by presenting at highly respected national conferences and publishing in national/international journals.

Some examples of the many on-going clinical research projects in the Trauma Burn Center:

In burn injuries, complications such as hypertrophic scar formation, wound infection, and multiple organ failure are related to size/depth of the burn. There is a progressive cell death and apoptosis that extends to several days after the initial thermal injury. Progressive cell death of the burn wound will significantly influence the clinical outcome. Our goal is to modify the burn-induced apoptosis of the epithelial cells and prevent conversion of a partial-thickness burn, which may heal primarily, to a full-thickness burn.

Critically injured patients are not a homogenous group, and the state of their inflammatory response is in flux, ranging from hyperactivation to immunosuppression. The cellular control switches that regulate these responses include an extensive network of intracellular signal transduction pathways, such as the mitogen-activated protein kinase (MAPK) families. Our ultimate goal is to evaluate and modify the innate immune response post-injury by analyzing and changing the MAPK activation status.

Analyzing the frequency and type of deep venous thrombus (blood clots) in trauma and burn patients. Developing a more effective way to detect and prevent them.

Reviewing the success and outcome of utilizing new "artificial", bio-engineered skin substitute products and technologies (examples: TransCyte and Integra).

Participating with ~ 35 other trauma centers across the nation to evaluate blunt traumatic injury to the small bowel. This is an infrequent, but difficult injury to detect. Results will be used to develop national guidelines for diagnosis and treatment.

Reviewing treatment and outcome of necrotizing fasciitis, a rare skin disease on which there is currently little published information. Although infrequently seen nationwide, many cases of this devastating disease are referred to our center.

Analyzing the incidence, type, and location of occupation-related electrical injuries. These results are being used to assess injury prevention education and intervention needs.

Evaluating a new intravenous drug used for the prevention of ulcers, a complication that critically ill burn and trauma patients are at high risk of developing.

Collaborating with a disease management company to identify and test more accurate predictors (such as blood pressure level, age, number of injuries) of how long a patient may be hospitalized.

Quantifying risk-taking behaviors of the elderly when driving (example: use of seat belts and/or alcohol intake).

Nationwide, injury prevention education regarding risk-taking behavior is typically targeted at younger drivers. However, our research indicates that incidence of seat belt and alcohol use in the elderly is fairly high.

Evaluating the use of new radiology technologies to treat complex traumatic injuries to arteries (blood vessels) and potentially reduce the need for an open surgery to occur. Analyzing throughput in operating rooms in order to provide best service to patients.

Documenting and reviewing our practices for diagnosing and treating pelvic organ injuries associated with pelvic fractures in order to report our findings to other trauma clinicians. Preliminary information indicates our center treats more of these injuries and has higher survival rate than is published by other centers.

Assess the impact of dialysis therapy on patient outcome. Findings may provide a guideline for future treatment of kidney failure (a complication of shock) in critically ill burn and trauma patients.

Reviewing the incidence and outcome of burns caused by gasoline being used as an accelerant. Findings will be utilized to evaluate effectiveness of current treatment practices and to focus injury prevention education.