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March 15, 2013

Other Views: Progress, at great cost

Scripps Howard News Service

— The grim truth of modern warfare is that it is a tremendous driver of medical innovation.

As the 10th anniversary of the Iraq war approaches, there have been considerable developments: from on-the-scene trauma treatment to the laborious process of rebuilding shattered bodies almost from scratch. U.S. troops wounded in Iraq and Afghanistan have a 90 percent chance of survival. In Vietnam and even the Gulf War, just 76 percent of the wounded survived.

Army Master Sgt. Todd Nelson’s is a case in point. In 2007, he was found on a street in Kabul, Afghanistan, surrounded by the flaming wreckage of his vehicle and the scattered remains of a suicide bomber. In an earlier war, he likely would have died.

Nelson had a fractured skull and crushed facial bones; his nose, right eye and right ear were gone; burns covered more than 18 percent of his body. He was unconscious for six weeks, waking up in the burn unit of the Brooke Army Medical Center in Fort Sam Houston, Texas.

Today, the 40-year-old Nelson has a prosthetic blue eye and a prosthetic ear. Reconstructive surgery and skin grafts have made his face as whole as today’s technology allows.

The military’s medical services have made an impressive array of gains: progress in front-line treatment; significant improvements in diagnosing and treating traumatic brain injuries; radical advances in artificial limbs, so much so that soldiers who have lost legs or arms have returned to active duty. Some techniques smack of science fiction: the regeneration of skin from the patient’s own stem cells and body fat, even spray-on skin harvested from the patient’s own skin cells.

Col. Robert Hale, who specializes in reconstructive surgery at the Army Institute of Surgical Research, recently told science writers that the wars in Iraq and Afghanistan may be remembered for the advances in regenerative medicine they prompted and expressed the hope that “within 20 years we’ll be able to regrow an entire face from the patient’s own cells.”

The insights learned from keeping wounded warriors like Nelson alive are quickly being disseminated in the emergency rooms, ambulances and surgical departments of civilian medicine.

Those advances must not be squandered, because they came at a high price — 5,200 American dead and more than 50,000 wounded. The medical knowledge we’ve gained in some small measure justifies their sacrifice.

Scripps Howard News Service

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