Genitourinary Injury and Lower Abdomen Reconstruction

Genitourinary Injury and Lower Abdomen Reconstruction are a newly developed focus area and are the result of complex blast injury (CBI). CBI may be defined as:

"An injury caused by an explosion, occurring to a Service Member while dismounted in a combat theater that results in amputation of at least one lower extremity at the knee or above, with either amputation or severe injury to the opposite lower limb, combined with pelvic, abdominal or urogenital injury."

Additionally, while not meeting the criteria for CBI, approximately 1 out of 3 non-CBI traumatic amputees (58% of all traumatic amputation cases for the time period under study January 1, 2012 to June 1, 2012) sustained a concomitant genital and/or abdominal injury.

While CBI is a relatively infrequent event, with rates between 1 and 8%, the permanent and catastrophic impairment to the genitourinary and lower abdomen region is one where few therapeutic strategies exist to restore form and function to our Wounded Warriors.

Our efforts in genitourinary injury repair and lower abdomen reconstruction will focus on:

• The advancement of pelvic reconstruction strategies to address injuries to the anus
• The advancement of urogenital reconstruction strategies to address injury to the genitalia (penile, scrotal, urethral tissues), perineal tissue and bladder

As advancement in this new focus area is also heavily dependent on tissue engineering technologies it will be closely integrated to the tissue reconstruction strategies and efforts executed in the other focus areas and will therefore leverage from their experience and best practices.

References:

• Report of the Army Dismounted Complex Blast Injury Task Force, 28 April 2011, p 6