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Partnership improves care, prosthetics for wounded warriors

Experts across the DoD and VA come together to collaborate on research and innovation through the Extremity Trauma and Amputation Center of Excellence. (U.S. Navy photo by Petty Officer 1st Class Anastasia McCarroll) Experts across the DoD and VA come together to collaborate on research and innovation through the Extremity Trauma and Amputation Center of Excellence. (U.S. Navy photo by Petty Officer 1st Class Anastasia McCarroll)

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With a goal to improve prosthetics for wounded warfighters, the Extremity Trauma and Amputation Center of Excellence, or EACE, fosters research, collaboration, and innovation.

“Our role is to build collaborative initiatives to maximize benefits for our service members and veterans,” said Jason Highsmith, a Department of Veterans Affairs employee who serves as deputy chief of research and surveillance for the EACE.    

Established in 2009, the center brings together the Departments of Defense and Veterans Affairs to make prosthetics more comfortable and better fitting through top notch research and innovation.

“These initiatives are in the spirit of collaborative research,” said Highsmith, who added that the multisite, multisector research aims at larger studies and a bigger vision in the projects. “To attain this goal, we must be truly collaborative across sites and sectors.”

Part of that collaborative partnership between the two departments includes clinical research with teams in military treatment facilities caring for wounded warriors. The EACE is able to facilitate synchronization of research across both departments and helps to centralize coordination of research and surveillance. Rachel Evans, a DoD employee and EACE research strategic planner, said the teamwork is critical to improve care for patients.

“It’s all geared toward a better quality of life as the patient moves through the entire federal system, from the point that they’re injured to the point that they receive VA life-long care or leave the VA,” said Evans. By working together, both departments can look at patient care longitudinally as patients transition from DoD care to VA care, she said.

Numerous DoD-funded multisite projects are in progress for extremity trauma care, Highsmith said. This includes studies looking at prosthetic interfaces to determine which maximize comfort and minimize thermal and skin-related problems, and the management of extremity trauma by way of orthotics, such as braces. Another study underway involves developing an algorithm to help providers and patients figure out what type of prosthetic foot, out of more than 100 types available, is best for them.

This center of excellence has embedded Army civilian researchers and DoD grant-funded researchers at advanced rehabilitation centers, which had limited research ability until then, said Evans. It helps coordinate and centralize research and surveillance across both departments, which allows researchers to provide a wider picture of care for patients.

John Shero, the center’s director and a DoD employee, said the organization is unique for being the only Congressionally established center of excellence with a mandate to conduct research. The mandate requires the center to perform research to gather information that can help save injured extremities, while repairing and maintaining function in injured limbs.

“We have strong collaborations with the VA within the three DoD advanced rehabilitation centers,” said Shero. The rehabilitation centers are located at Walter Reed National Military Medical Center in Bethesda, Maryland; Brooke Army Medical Center in San Antonio, Texas; and Naval Medical Center in San Diego, California.

“The things we do are the kinds of things that can’t be done independently at the military treatment facilities,” said Shero.

The organization’s work extends beyond studies, including creating a joint amputation care network. Its clinical informatics teams have created a registry on patients with amputations and extremity trauma, while the clinical affairs team spearheaded clinical practice guidelines on upper and lower extremity amputation rehabilitation.

“Being able to pull it all together cohesively, to present the larger picture of what we’re doing, from preventing injury all the way to the point where the rehabilitated patient moves out into the VA and is enjoying their civilian life, is the real value proposition of the centers of excellence,” said Evans. “Stronger together is truly the way we work.”

For more information on the EACE, visit the Extremity Trauma and Amputation Center of Excellence.


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