In recent wars, our military was able to use helicopters and other transportation to remove injured Warfighters to hospitals to receive care. The future battlefield will not allow for this, and medics will have to take care of injured casualties for several days with whatever they can carry in their packs. As such, we must provide the medics’ pack with versatile treatments that are lightweight and can be used for a variety of injuries they will see on the battlefield. This is the crux of the focus area in the call for proposals, to solicit “Research and development of wound decontamination solutions… and extracellular materials for wound care therapies to stabilize wounds, accelerate healing, and prevent complications.” Two common wound types that will be encountered in this scenario are bleeding and burns, both of which are more severe and complex in military casualties than what is seen at civilian trauma centers.

Bleeding (hemorrhage) is a major cause of death on the battlefield, and difficult to stop in the prehospital environment with several available techniques. The most straightforward are tourniquets, which are put in place closer to the heart in order to stop bleeding from, for example, the arms or legs. However, when the bleeding is somewhere that a tourniquet cannot help, dying from bleeding is a serious problem. While there are different dressings on the market, most can be thought of as band-aids, and a type of gauze that could stop severe bleeding on contact with the blood vessel has the potential to save lives.

If a Soldier or patient is burned on a large portion of their body, there can be serious side effects beyond those immediately apparent on the skin. The body’s immune system starts to become very active causing inflammation, which elevates body temperature and heart rate. The burned skin itself causes some of these problems and can also harbor bacteria. Because of this, a patient would ideally be seen at a hospital where they would surgically remove the burned skin and try to cover the wound from the outside environment. In the absence of this possibility, the military has a need to identify solutions to temporarily provide coverage of the wound at the point of injury.

Towards this end, a novel universal combat matrix (UCM) with promising hemostatic and wound repair properties may be able to help treat both bleeding and burns. UCM can be applied with little training, is lightweight, and requires no special storage. UCM is tunable such that it can be made into a fabric-like dressing or a topical cream. This material has demonstrated exciting potential as a multimodal wound dressing in initial pilot studies for hemostasis and wound healing. However, this novel material has yet to be rigorously tested in preclinical models.

This proposal will test this material in swine models of hemorrhage and burns. Pigs are used for research many reasons – their similar size to humans means that total blood volume and blood vessel size are clinically relevant. In fact, this has led to the potential for using pig organs in transplantation.

For burn research, their skin has a variety of pigmentation, like humans, as well as similar hair distribution and wound healing mechanisms. As a consensus decisive proof-of-concept model, testing UCM in these large animals will give definitive evidence on whether this material should be marketed and used on our Warfighters. The ultimate goal of this line of research is to provide our military medics with a medical treatment that will save the lives of our deployed active-duty members.