Vanderbilt University Medical Center is one of three clinical sites testing new products to replace burned skin as part of a federal grant program. The collaborative effort is expected to boost treatment options for soldiers injured in war zones.

The Armed Forces Institute of Regenerative Medicine (AFIRM) consists of two academic groups, or consortiums, working with the US Army Institute of Surgical Research to use regenerative medicine to develop treatments for wounded soldiers.

One consortium is co-led by the Wake Forest Institute for Regenerative Medicine and the McGowan Institute for Regenerative Medicine, and the other by Rutgers and the Cleveland Clinic. Each consortium was awarded $42.5 million over a period of 5 years.

Local public and private matching funds amounting to more than $180 million will be added for a total of more than $250 million available for the research.

Specific areas to be addressed, include better treatment of burns, injuries to the cranium, face and limbs, scarless wound healing, and compartment syndrome, which is related to inflammation after injury.

"This not only helps the combat injured, but every injured person in every community in this country," says co-investigator Jeffrey Guy, MD, director of the Vanderbilt Regional Burn Center. "AFIRM is pooling experts from universities across the country and it is going to be a very concerted effort to advance the science in these specific injuries. It’s a Herculean task that is being coordinated by folks at the Department of Defense, and it is very exciting."

Vanderbilt will focus on clinical therapies for burn victims as part of the Wake Forest-McGowan consortium, which leverages more than 375 faculty members focusing on regenerative medicine.

In addition to Guy, the Vanderbilt team includes Lillian Nanney, PhD, professor of plastic surgery and cell and developmental biology, and Blair Summitt, MD, a plastic surgeon.

Guy says improvements in burn survival have largely been in critical care, dealing with how to support patients with organ failure or treatment of infection. Treating the burn wound itself hasn’t changed in nearly 4 decades, although there have been small, incremental improvements.

"The way we manage the burn wound now is very barbaric; we are robbing Peter to pay Paul," says Guy. "We are taking skin from one reasonably healthy place and putting it on the burn wound."

Guy and Summitt will work together to test regenerative products while taking care of burn patients at Vanderbilt.

"We’re seeing an unprecedented number of burn injuries among our soldiers in both Iraq and Afghanistan," says Summitt. "This early phase of the study should lay the groundwork for some exciting new developments. We’re hopeful that this work will initiate development of new products and inspire commercial interest in this arena."

Nanney will pursue testing of pre-clinical discoveries, such as engineered skin products, bio-printing of skin in the field, and repairs using stem cells derived from amniotic fluid. Nanney will also be designing and performing tissue analysis for all of the burn projects in the consortium.

"The goal of the burn team within AFIRM is to assemble bioengineered skin substitutes containing stem cells that will regenerate better than any products invented to date," says Nanney. "The number of burn victims in America is much smaller than the number of elderly patients with chronic wounds so companies don’t develop new products because they are few and far between in the big picture. This is an initiative to really move this area forward and help soldiers wounded in combat and also burned civilians because, otherwise, industry and science have neglected this area."

[Medical News Today, April 20, 2008]