We want to identify the types of injuries that have led to early amputation and those which are amenable to salvage. In addition we aim to develop and to clinically deploy technology for limb salvage and limb regeneration that will be appropriate wherever blast injuries occur. To achieve this, we have the following research aims:

1)  Identify patient characteristics that have led to early avoidable amputation;

In this work package we will be determining the surgical problems that are encountered in LMICs, predominantly looking at Sri Lanka, and how amputation might be avoided. We will discuss issues with surgeons from Sri Lanka and Lebanon, and also with UK surgeons who have experience of working in conflict and post-conflict environments. 

Work package leads: Bull, Karunaratne, Abu-Sittah.

2)    Provide immediate surgeon education for limb salvage/amputation using state of the art techniques;

Using the information gathered from the research above, we will plan and deliver a training course for surgeons. We will create strong links between surgeons in the UK and Sri Lanka by providing hands-on training, sharing information about techniques and providing ongoing mentoring from UK surgeons. Training will be enhanced through augmented reality training tools.

Work package leads: Cobb, Hettiaratchy, Abu-Sittah.

3)  Develop simple, low cost bespoke instruments and implantable devices to maximise the extent of limb salvage

As part of this aim we will prepare fixation devices that are suitable for the injuries sustained in conflicts, and which are able to be manufactured in relevant settings. These technologies will be transferable to other musculoskeletal trauma that can be suffered e.g. during road traffic accidents (a common problem in many LMICs).

The team will also be looking to develop a structural biomaterial scaffold that shares load with the host tissue, guides tissue repair, and then resorbs, leaving the patient with no legacy of implants that may cause future problems.

Work package leads: Jeffers, Cobb, Bull, Clasper, Stevens, Jones, Karunaratne.