Citation

Baer D, Donaldson R, McKinley T, Guldberg R. Trauma Surg. Acute Care Open 2021; 6(1): e000765.

Copyright

(Copyright © 2021, The author(s) and the American Association for the Surgery of Trauma, Publisher BMJ Publishing Group)

DOI

10.1136/tsaco-2021-000765

PMID

34212117

Abstract

While overall trauma research and development funding has a long history of being woefully underfunded in comparison to its societal impact, one saving grace has been the longstanding synergy between military and civilian activities. The crucible of war and caring for those injured in combat has driven innovation in every area of trauma care, with numerous recent examples from Afghanistan and Iraq alone. From large-scale innovations such as medical evacuation, to individual devices such as hemostatic dressings, high-impact research, development and innovation has been spurred by military medical necessity, investment and use. This is captured in the adage that the only winner in war is medicine. Military innovations in trauma have spread widely to the civilian arena, where they are more carefully studied and further refined. While it is tempting to examine military medical innovation in the isolated context of military use, the beneficial back and forth between military and civilian trauma care is an essential, not optional, step to ensure maximum benefit to military casualties. The overlap between civilian and military trauma care and innovation has thus been of mutually reinforcing benefit.

Many journals and publications have consistently and correctly identified the need for a civilian counterpart to the military's investment in trauma care. Most recently articulated by Glass et al, the National Institutes of Health (NIH) has failed to fund this vital research area at levels matching the problem's scope, which in turn costs untold deaths and disability. Unfortunately, this problem is on the precipice of suddenly worsening, as highlighted by a recent panel discussion between the director of military trauma research and the civilian NIH Office of Emergency Care Research. These leaders presented a growing disconnect between the agendas of these two main funding organizations, as the military adjusts to future combat threats and leaves a void in traditional trauma research that the NIH lacks the current resources to fill.

Given changes in national strategic focus, the US military has recently adapted its trauma research and development activities towards future battlefield challenges that are envisioned to be unlike current or recent wars. This future is termed the multidomain battlefield (MDO)...

Language: en

Keywords

wounds and injuries; policy; research; war-related injuries