Development of a Novel Multi-Stage Limb Salvage Technology for the optimisation of tissue viability in severely injured limbs.
Lead Research Organisation:
University of Strathclyde
Department Name: Biomedical Engineering
Abstract
Objectives:
To develop an integrated technology for the preservation of tissue in injured limbs as a result of battlefield injury or severe trauma.
The overall objective is to stabilise the casualty and to enhance tissue viability during the evacuation process using novel technologies founded on techniques employed for tissue preservation in other ranches of medicine such as cardiac surgery and organ transportation. The fundamental research question being addressed by this research is "Does rapid isolation and cooling of limbs at the point of injury, combined with isolated perfusion, enhance tissue viability and ultimate limb recovery?"
Novel engineering:
The project will focus on the impact of combined novel alternating pneumatic tourniquet and topical gas cooling of the tissues on tissue viability in a simulated casualty evacuation environment. The preserved limbs are then placed on an extracorporeal circulatory support system with an automated control system to re-establish perfusion to the limbs with adequacy of circulation monitored using tissue oximetry and laser Doppler flow measurement. The impact of the preservation technique is assessed using nerve stimulation and histological assessment after a period of perfusion. The results of the end stage assessment is used to inform decisions regarding the factors influencing the adequacy of the early preservation steps. Additional in-vitro experiments are carried out to assess the temperature profile of isolated tissue under differing cooling conditions, using infra-red thermal camera techniques. Using this approach, we are able to interpret the positive and potential negative impact of thermal prorogation on tissue preservation to tune the cooling cycle, for example to prevent surface frost bite as a consequence of the technique. This use of these various investigative techniques, combined with the development of new portable tissue preservation technologies are represent an entirely novel engineering approach in this field of emergency medicine.
To develop an integrated technology for the preservation of tissue in injured limbs as a result of battlefield injury or severe trauma.
The overall objective is to stabilise the casualty and to enhance tissue viability during the evacuation process using novel technologies founded on techniques employed for tissue preservation in other ranches of medicine such as cardiac surgery and organ transportation. The fundamental research question being addressed by this research is "Does rapid isolation and cooling of limbs at the point of injury, combined with isolated perfusion, enhance tissue viability and ultimate limb recovery?"
Novel engineering:
The project will focus on the impact of combined novel alternating pneumatic tourniquet and topical gas cooling of the tissues on tissue viability in a simulated casualty evacuation environment. The preserved limbs are then placed on an extracorporeal circulatory support system with an automated control system to re-establish perfusion to the limbs with adequacy of circulation monitored using tissue oximetry and laser Doppler flow measurement. The impact of the preservation technique is assessed using nerve stimulation and histological assessment after a period of perfusion. The results of the end stage assessment is used to inform decisions regarding the factors influencing the adequacy of the early preservation steps. Additional in-vitro experiments are carried out to assess the temperature profile of isolated tissue under differing cooling conditions, using infra-red thermal camera techniques. Using this approach, we are able to interpret the positive and potential negative impact of thermal prorogation on tissue preservation to tune the cooling cycle, for example to prevent surface frost bite as a consequence of the technique. This use of these various investigative techniques, combined with the development of new portable tissue preservation technologies are represent an entirely novel engineering approach in this field of emergency medicine.
Organisations
People |
ORCID iD |
| Terence Gourlay (Primary Supervisor) | |
| Victoria Morton (Student) |
Studentship Projects
| Project Reference | Relationship | Related To | Start | End | Student Name |
|---|---|---|---|---|---|
| EP/N509760/1 | 01/10/2016 | 30/09/2021 | |||
| 1828020 | Studentship | EP/N509760/1 | 01/10/2016 | 31/03/2020 | Victoria Morton |
| Description | It has been discovered that when using the topical gas cooling method designed for this project, it is possible to cool small-scale tissue samples by more than 10 degrees Celsius, the target temperature reduction. This temperature reduction is statistically similar to that produced when using ice, the current practice for cooling tissue in response to injury. The topical cooling technology of gas combined with a coolant fluid is also able to cool the deep tissue in sheep limbs by more than 5 degrees Celsius. |
| Exploitation Route | The outcomes of this funding can be taken forward to inform further development and refinement of the technology. The outcomes show that the cooling technology works as a proof of concept. The technology can then be developed in combination with healthcare professionals and military medics to enable the technology to be applied in the most effective manner for them. Working with the healthcare professionals and military medics will help create technology to improve tissue salvage in major trauma at the point of injury. |
| Sectors | Aerospace, Defence and Marine,Healthcare |