The NIHR Surgical Reconstruction and Microbiology Research Centre (SRMRC) is a national hub for trauma research – sharing the best clinical practice from the military frontline to the NHS and back again.
The aims of the SRMRC are to learn more about how our bodily functions are compromised by injury, and which factors may influence how well a patient recovers. By combining knowledge gained in these areas, we can meet another aim – to discover how to reduce the negative effects of traumatic injury.
Multiple studies are run from the SRMRC all year round by a multidisciplinary, collaborative team of scientists, academics, dedicated research nurses and administrative staff. Through this expert team, the centre is able to tackle some of the biggest questions in trauma.
At any one time, more than 30 clinical trials are being delivered by the SRMRC’s 24/7 research team. Two key examples of studies currently running include the RePHILL trial – asking which is best for a patient who needs to maintain their blood volume at the scene of the injury – blood or saline, and SIFTI-2 designed to look in-depth at what happens after people sustain a large burn in order to develop novel tests to identify patients who are likely to develop sepsis.
Research is carried out across several key themes:
This theme includes studies looking at: repetitive concussion in athletes and developing a device that will tell if someone is concussed using only their saliva; measuring blood flow in the eye to assess and treat sepsis; and rapidly diagnosing the presence of an infectious agent in the field and by the bedside which was used in the recent Ebola outbreak.
The Centre is unique in that it has established the set-up to be able to collect blood within the first hour of injury enabled by its partnership with paramedics within the West Midlands. One such study, under this theme, is called Golden Hour and is revealing what happens to the immune system in that crucial first hour after injury and why some patients develop sepsis and others do not.
Other studies include: characterising the changes in a vulnerable trauma patient’s gut microbiome; determining whether injury accelerates the ageing process in trauma patients; and understanding the immediate physiological responses to severe burns.
Re-enablement – giving patients the confidence and guidance to relearn skills they may have lost due to injury – is an important precursor to effective rehabilitation.
This theme includes studies that help patients communicate when in intensive care, and which further our understanding about how pain just after an acute trauma can lead to ongoing (chronic) pain and disability.
Work under this area includes the development of special wound dressings that can promote scar-free healing and research into how to stimulate the laying down of new bone material to ensure bones heal correctly and amputees do not suffer from inappropriate and painful bone growth in their residual limbs. It also includes the development of antimicrobial technologies to prevent contamination and infection.
Examples of projects in this area are: using a heavily diluted version of vinegar to aid wound healing in burns patients; investigating how to reduce muscle loss after injury; and reducing the risk of sight loss after brain or eye injury.