Capturing the Full Power of Biomaterials for Military Medicine Report of a Workshop (2004) / Chapter Skim
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2 Biomaterials Technology Assessment and Roadmapping
2 Biomaterials Technology Assessment and Roadmapping
Pages 10-27
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From page 10... ...
Members of the breakout session listed the characteristics of an ideal wound care product as follows: · Can be self-administered or be easily applied by a medic or colleague; · Can be rapidly applied; · Acts rapidly and is functional from the moment of wound or tissue contact; · Reduces blood loss; · Reduces infection; · Inhibits or reduces contamination; 1 Edward F Bruner.
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From page 11... ...
Breakout session members indicated the need for a safe, effective replacement for morphine that can both be easily and quickly applied and have immediate effect.
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A number of metrics were suggested by the wound care breakout session members, including the following: · A wound care system that combines wound cleaning, wound closure, infection control, and pain management; · Effective and cheap bandages that cost 10 percent of the cost of advanced bandages in current use; and · Ultralightweight splints that weigh less than a pound and can be applied in less than a minute. TISSUE ENGINEERING When a wound is very severe, much more than battlefield medicine is required.
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From page 13... ...
Most fatal penetrating injuries were caused by missiles entering areas not protected by body armor, such as the face, neck, pelvis, and groin. Three patients with penetrating abdominal wounds died from exsanguination, and two of these three died after damage control procedures.
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From page 14... ...
at the wound site.13 A further alternative would be to develop permanent artificial replacements for injured limbs, organs, or tissue that, unlike current technologies, restore full function and integrate fully with existing bone, structure, and tissue. There was agreement among breakout session members that achieving any or all of these solutions for the repair of severe tissue injuries will require the development and understanding of new biomaterials.
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This was clear from a quick assessment of the backgrounds of breakout session members as well. Applying any new technologies and developing usable products will also require ongoing, active cooperation between members of commercial, academic, regulatory, and military organizations.
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Also, during this mid-term period, participants believed that bioactive biomaterials will be able to enhance the development of new blood vessels, promoting better healing and preventing infections during bone and muscle repair. Workshop participants were aware of the long-term potential of cell therapies.
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For the longer-term (5 years and beyond) , workshop participants emphasized such tasks as improving blood flow through vessels by increasing patency, developing artificial blood vessels made of resorbable materials that are replaced over time by functional natural blood vessels, and making artificial blood vessels that do not induce blood clotting.
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From page 18... ...
A number of metrics were suggested by the tissue engineering breakout group members, including · Implementation of bone void-fillers within 1 year; · Incorporation of bioactives into implanted artificial blood vessels within 3 years; · Development of load-bearing, biocompatible polymers and composites within 5 years; and · Development of anti-fibrogenic nerve conduits within 7 years. DRUG DELIVERY Workshop attendees assigned to assess drug delivery needs first focused on the current state of therapeutic areas and enabling biomaterial technologies that could enhance casualty prevention and management.
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However, breakout session members estimated that at least double the current number of vaccines may be required in the future. This large number of vaccines represents not only a significant number of inoculations for service members, but also an enormous logistical and medical administration challenge given that most vaccines require multiple booster immunizations to achieve full protection.
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Advanced biomaterials are required that increase the effectiveness of analgesics, decrease the requirement for repeated dosing, and allow topical or regional application.22 Enabling Biomaterial and Drug Delivery System Technologies Enabling technologies are those that generally improve the development of biomaterials for many applications. Biomaterials are the underpinning of any method of drug delivery.23 Relevant factors noted by breakout session members include the development of new biomaterial drug or vaccine carriers or other delivery systems, new methods of administration, new combinatorial approaches for materials design, and rapid effective screening methods.
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Enabling Biomaterials and Drug Delivery Technologies A goal identified by breakout session members was to decrease the time required to deliver new biomaterials to these applications by 50 percent. Incumbent in this is a need to develop better combinatorial libraries and screening methods for specific compounds.
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From page 22... ...
Measures of Success The following performance metrics were suggested by workshop participants for products developed for drug delivery in military applications: · In the near term, implement methods to deliver bioactives to wounds using powders, films, and dressings. · In the mid-term, reduce by 50 percent the pain management burden on the battlefield after trauma.
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From page 23... ...
These sensors are typically powered by alkaline batteries, which have a short useful life and are relatively heavy. Periodic monitoring is done of the heart rate using commercially available electrocardiogram sensors.
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Currently, the data needs for prevention of nonbattlefield injuries are known and include heart rate, core temperature, hydration, and metabolic rate. Research is ongoing for casualty management and for sustenance of performance.
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From the soldier to the medic, data could be transmitted using radio-frequency signals. · Determination of useful physiological data that the field medic may be able monitor with sensors for casualty management -- respiration, heart rate, and the core and skin temperature of each field soldier are the first needs.
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From page 26... ...
An example is sensors that do not require contact with the skin. Some potentially enabling technologies under investigation for this include micro-impulse radar technology that can detect respiratory rate and heart rate through clothing; range-finding radar that can operate with very low power, in the range of 1/1,000 of the power of a cell phone battery; and capacity-coupled noncontact electrocardiogram systems that have been shown to get good results through clothing.
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From page 27... ...
Measures of Success The following performance metrics were suggested by workshop participants for products developed for physiological sensors and diagnostics in military applications: · In the near term, make lightweight location transmitters available for every field soldier. · In the near term, develop a high-level system of diagnostic needs that will help to optimize sensor needs and facilitate the development of the most important combinations of sensors.
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