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Remarkable Advances, Impressive Gains
Stationed at the 28th Combat Support Hospital near Fallujah, they developed a technique that involved delicately removing part of a patient's skull to allow the brain to swell instead of put pressure on the brainstem, which could cause irreversible coma. After closing the scalp, doctors ensure the brain receives plenty of blood by using micro-balloons and medication to unclog any narrowing blood vessels--treatment similar to what stroke victims receive. After several months, once the brain swelling recedes, doctors use a computer-generated model of the patient's head to create a hard acrylic implant that they insert when closing up the skull.For this bit of medical wizardry, the doctors were nicknamed the Skull Crackers. "Our breakthrough was in treating a traumatic brain injury like a stroke," says Rocco Armonda, MD, one of the Skull Cracker neurosurgeons now serving at National Naval Medical Center in Bethesda, Maryland. "If you can open the skull early enough to prevent secondary injuries like low blood flow, the chances of recovery are better than ever." Indeed, Dr. Armonda estimates that the survival rate of neuro-rescued brain- trauma victims has risen to more than 50 percent and more than a third have returned to independent living -- working, driving a car and even attending college.
Meanwhile, neuro-rescue techniques are slowly being adopted in hospitals in the States, where 1.4 million Americans suffer TBIs every year. After ABC News anchor Bob Woodruff sustained a brain injury in Iraq, he received the pioneering treatment under Dr. Armonda's care last winter.
The Ultimate BandageSince the dawn of warfare, a major killer of soldiers on the battlefield has been severe bleeding. Even today in Iraq and Afghanistan, many of those who die in combat bleed to death in the minutes before they can be evacuated to an aid station. But that tragic toll may soon decline with the development of an innovative dressing called the HemCon Bandage. Made with chitosan (pronounced KY-tuh-san), it uses an organic substance from shrimp shells to help blood cells form clots. A four-inch-square dressing can staunch a heavily gushing wound in 30 seconds and has been shown to stop or reduce bleeding in more than 90 percent of combat cases.
"It acts like a tire patch," says Col. Robert Vandre, the U.S. Army's director of Combat Casualty Care Research at Fort Detrick, Maryland. "It's not sticky until it gets in the presence of blood. Then it adheres to the surrounding tissue and seals off the blood like no other conventional bandage."
Created by scientists at the Oregon Medical Laser Center under a grant from the U.S. Army Medical Research and Materiel Command, the HemCon (for "hemorrhage control") Bandage works because the positively charged chitosan material bonds with negatively charged blood cells to form an artificial clot. When researchers first demonstrated the bandage's effectiveness in 2002, the Food and Drug Administration gave it fast-track approval in a matter of days. Since then, the Army has made the $85 bandage standard issue for all American soldiers serving in Iraq and Afghanistan. And military reports credit the bandage with already saving more than 100 lives. In mid-2006, the manufacturer, Portland-based HemCon Medical Technologies Inc., began marketing the bandage to civilian medical personnel, including ambulance drivers and emergency room doctors.
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