AP IMPACT: Surprising methods heal wounded troops

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The second approach uses sheets of skin developed from cells in the lab that originally came from foreskin after circumcisions.

“That’s in clinical trials now and they’re having tremendous results,” Irgens said.

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Beyond “bionic arms” to transplants

For all the advances that have been made in modern prosthetics, the arms and hands are not as effective as the legs and feet. Dozens of wounded troops would rather try a transplant.

The government also estimates that up to 200 troops might need face transplants, although Dr. Bohdan Pomahac, a Boston surgeon who has done four face transplants on non-military patients, thinks only 50 to 100 ultimately will get one.

One reason is the lifelong drugs needed to prevent rejection. They have side effects and raise the risk of cancer.

Dr. W.P. Andrew Lee, plastic surgery chairman at Johns Hopkins University, has been working to minimize those risks. Previously, at the University of Pittsburgh, he led hand transplants on five patients with minimal immune suppression, giving them bone marrow taken from their donors along with the hands to help them better tolerate the new tissue. All five patients have done well and four now take just one anti-rejection drug.

“There’s really no reason to think faces will be any different,” he said.

He also showed that rejection can often be stopped by rubbing on a cream containing immune-suppressing medicine.

“Skin is the primary target of the rejection,” he explained, so with a hand transplant, “we can detect rejection much earlier than we can for organ transplants. The patient literally calls us. They notice a rash on the skin first thing in the morning. We just tell them to put the cream on.”

With military funding, a host of doctors are evaluating troops as potential face transplant candidates. Pomahac told of one man who lost much of his face, jaw and lips in a bomb blast. Despite 25 operations, he still can’t move one side of his face or lips and drools all the time.

“He walks around with a towel on his shoulder. It’s a major quality-of-life issue,” Pomahac said.

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Advancing reconstructive surgery

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