Recovery code: why the Ministry of Defense created the center for the study of wounds

In early February, the first center for the study of modern wounds was opened in Russia. The need for it arose due to a radical change in the course of armed conflicts, experts explained. In particular, we are talking about the massive use of drones with high-energy ammunition: fragments tear through tissues at speed, and the necrosis zone reaches 6 cm. This changes the traditional picture that doctors see in front of them when they deliver a wounded person. The purpose of the laboratory is to combine the work of scientific institutes, industrial partners and doctors in order to minimize the risks of amputations, infections and disabilities.

Trauma Laboratory

The creation of a Target Search Laboratory for Modern Combat Surgical Trauma (CPLSBS) together with the Foundation for Advanced Research is a reaction to the evolution of enemy weapons, says the head of the laboratory department of the GVKG named after him. Burdenko, Major of the medical service, Candidate of Medical Sciences Vladimir Besedin. According to him, bullet wounds used to prevail, now there are multiple fragmentation and mine-explosive wounds.

— In particular, high-energy ammunition on drones causes explosive thermobaromechanical injury. An explosion at a distance of 5-10 meters accelerates the fragments to a terrific speed: they not only cut, but transmit the energy of the explosion, causing tissue contusion 15 cm around. The zone of primary necrosis reaches 3-6 cm, and the damage affects muscles, nerves and blood vessels. The risk of amputation, infections and disability is increasing," he explained.

The specialist recalled that Russian Defense Minister Andrei Belousov had set the task for the development of new technologies for the treatment of combat surgical trauma to be organized and implemented not only at central hospitals, but also distributed and replicated at district medical centers.

According to Vladimir Besedin, there are many domestic developments and research areas in Russia, but they are at different stages of readiness and are in no way related to each other. The new high-tech medical center will bring together scientific enterprises, industrial partners and doctors in order to create a comprehensive platform or system for developing technologies for the treatment of modern combat surgical trauma.

— In this case, a continuous "seamless technique" will be implemented — parallel treatment, research and production of equipment. Doctors operate, scientists test drugs, and partners adapt devices to meet real needs. The output is not concepts, but implemented innovations," said Vladimir Besedin.

Our interlocutor listed the priorities: the suppression of antibiotic-resistant infections, biomaterials for bone replacement, limb reconstruction tools, and protocols for returning to combat missions.

— The center focuses on preserving organs, restoring abilities and reducing losses. The developments will be transferred to district and naval hospitals and the civilian sphere, from oncology to transplantology," he summed up.

Implants in hours

Only an in-depth analysis of the consequences of the use of modern weapons of destruction, together with the introduction of promising diagnostic systems, will help significantly reduce mortality and disability rates, stressed the head of the GVKG im. Burdenko is a major general of the medical service Denis Davydov.

— The enormous experience accumulated during the time of its development has no global analogues. Now this knowledge needs to be turned into standards suitable for district hospitals across the country. The laboratory will become a link between fundamental science and the operating table," said Dmitry Trishkin, head of the Main Military Medical Directorate (GVMU).

The former head of the medical service of the Baltic Fleet, Colonel Nikolai Karpun, in an interview with Izvestia, called the laboratory an evolution of military field surgery.

One of the most promising areas of the laboratory's work is additive manufacturing — 3D printing. When a fighter receives a severe injury to a limb or skull, extensive bone defects often form — "holes" in the skeleton that cannot be closed in the usual way. Previously, such treatment took years, required dozens of operations, and often resulted in disability.

Today, doctors are moving to individual design. A digital model of the missing bone fragment is created based on computed tomography data. Then, an implant is printed on a 3D printer made of medical titanium or special polymers, which perfectly matches the anatomy of a particular patient.

But an implant is just a framework. Cellular technologies are used to bring it to life. Doctors use the patient's own cells to stimulate tissue regeneration. This allows you to restore the bone structure where previously medicine was powerless. Recovery time is significantly reduced: what has been treated for years is now being fixed in months, military doctors emphasize.

Technological factory

Another ambitious vector is mobile hardware and instrument complexes. In the context of polytrauma, time is the most scarce resource. The new systems will allow rapid analyses to be performed directly in the ward, without wasting hours transporting biomaterials.

As reported by the director of the Russian National Research Center named after Petrovsky Konstantin Kotenko, the program has already been approved. After the experimental research stage, clinical testing will begin at the Burdenko Hospital.

In the conflict zone, time is the most scarce resource. The slightest delay in evacuation, diagnosis or the choice of a treatment method can cost a person his life, military expert Viktor Litovkin told Izvestia.

— The introduction of rapid analyses directly in hospital wards reduces the decision-making chain to a minimum. We are moving away from the complex logistics of biomaterials to an instant "bedside" result. This is critically important for the rescue of soldiers with serious injuries," he said.

The expert also noted the importance of scaling this experience to regions. The fighting and the main burden on the medical system fall not on Moscow or St. Petersburg, but on the border territories - Rostov, Kursk, Belgorod regions, and new regions. The closer modern technologies such as 3D-printing of implants and operative diagnostics are to the front line, the higher the chances of successful rehabilitation and saving the lives of our defenders.

The created structure is not just an institute, but a "technological factory" through which hundreds of innovations will pass, explained Maxim Vakshtein, CEO of the Foundation for Advanced Research.

— We are betting on a long-term period so that this site becomes a conveyor belt for selecting the best ideas. The entire potential of the country will be used, both military and civilian," he said.

The project brought together the elite of Russian science: the Military Medical Academy, the Ilizarov, Priorov and Petrovsky centers. The results of this work will be a breakthrough for the entire healthcare sector. Tissue culture technologies are critically important in oncology, transplantation and reconstructive surgery.