Muscle loss due to trauma, tumor resection or congenital malformation is devastating to the patient and their family. The loss of the ability to close one’s eyes, chew food or smile at a loved one leaves deep physical and emotional scars on the patient. Most current therapies involve creative rearrangement of skin and muscle flaps to mitigate the deformity. Since these procedures transpose tissues from other locations, the results are often sub-optimal. A percentage of mobilized flap tissues contract, atrophy and/or die and do not function like the original tissue. Skeletal muscle is one of the few tissues in the human body that has significant regenerative capacity. This capacity is due to the presence of satellite cells. These cells become activated and participate in the repair of damaged skeletal muscle. Unfortunately, large defects such as those created by some major surgical procedures cannot be healed regeneratively via endogenous satellite cells. Additionally, inherent inflammatory responses cause permanent scarring and further disfigurement.
Our research addresses the problem of muscle regeneration by combining modulation of inflammatory processes with tissue engineering-based regeneration strategies. The overall goal is to seamlessly regenerate fascicular segments of skeletal muscle.
Hemorrhagic shock kills civilians and soldiers alike. Patients who present with severe hemorrhagic injuries suffer from shock, acidosis, coagulopathy, and frequently hypothermia. Even with control of hemorrhage, many of these patients continue a clinical decline manifested by recurrent hypo-perfusion, ongoing volume requirement, systemic inflammatory response syndrome, loss of organ system function leading to multi-organ failure anddeath. The U.S. alone has approximately 42 million trauma patients annually, of whom 22% experience severe hemorrhagic injury. Hemorrhagic shock is one of the principal causes of death among soldiers who die within the first hour of wounding. Our research focuses on multi-component resuscitative fluids and strategies that directly address the needs of the cell during periods of low blood flow and warm ischemia.