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Dartmouth College Office of Public Affairs • Press Release
Improvised explosive devices (IEDs) cause severe multiple injuries to soldiers in Iraq and Afghanistan. On Dec. 3-5, Dartmouth will host a conference to discuss improved treatments for those with these multiple wounds, a condition referred to as polytrauma.
"Right now, there is no treatment process or approach to rehabilitation that adequately addresses polytrauma," says Joseph Rosen, a plastic surgeon at Dartmouth-Hitchcock Medical Center and an adjunct associate professor at Dartmouth's Thayer School of Engineering. "Although there are exceptions, current treatments generally focus on a single problem, such as limb loss or hearing loss. This approach is quickly overwhelmed by the polytrauma patient. During our conference at Dartmouth, we intend to bring together experts from multiple fields to consider how best to address the polytrauma challenge."
Rosen explains that new body armor combined with improved combat casualty care and rapid evacuation procedures increase the survival rate of wounded servicemen. But, there has also been a shift in the severity of the injuries. Polytrauma often includes injuries to the hands, feet, arms, legs, face, and brain, as well as impairment of vision and hearing.
"We shouldn't apply single-trauma treatments to polytrauma patients," says Rosen. "First, many of these treatments depend on the normal functioning of systems that have also been injured. Second, using independent treatments fails to capitalize on economies of scale, which can be realized with an integrated approach."
The conference, which is invitation only and is sponsored by Dartmouth, Stryker, Raytheon, and iRobot, will bring together leaders in industry, medicine, government, and academia to discuss both the short-term clinical efforts to rehabilitate current polytrauma patients and outline a long-term research effort to develop more effective treatments. Rosen says that new polytrauma treatments will also have substantial benefits for other populations. In particular, it might lead to significant benefits for the elderly and for patients of diseases such as cerebral palsy, muscular dystrophy, and spinal cord injuries that lead to multiple failures in normal functioning.
Rosen envisions a polytrauma program that considers all the injuries of each case in a unified fashion, and also engages and integrates organizations, disciplines, facilities, and personnel that cover a broad range of medical and rehabilitation domains (concerned with psychological as well as physical problems) and scientific and engineering components (biology, physics, chemistry, mechanical engineering, and electrical engineering). The successful program will involve individuals from academia, industry, and government, and individuals focused on program administration and funding as well as on the content of the Polytrauma program.
Also at the Dartmouth conference, which will be held at Dartmouth's Thayer School of Engineering, Rosen and his colleagues will discuss emerging avenues of treatment in robotic systems and arm and face transplants, and new research into regenerative tissues.
"We need to have focused energy on this issue, and I hope the Dartmouth conference is the first of many," he says.
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