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S.A. Being Positioned as Major Trauma Hub
November 11, 2007

L.A. Lorek Express-News Business Writer

San Antonio's military and civilian medical experts are positioning the city as one of the nation's major centers for trauma research and treatment.

"From a military standpoint, we have 500 deaths per year in a time of war, but the trauma problem is so much greater in the civilian world with 160,000 deaths annually," said Col. John Holcomb, commander of the U.S. Army's Institute of Surgical Research.

He leads a team of surgeons and researchers at Brooke Army Medical Center who conduct cutting-edge clinical trials. "To do trauma research, we need a lot of money."

To help with that effort, U.S. Reps. Charlie Gonzalez and Ciro D. Rodriguez, both San Antonio Democrats, introduced a bill, titled the National Trauma Institute Act, in late September. It would provide $100 million for the Department of Defense to fund the National Trauma Institute in San Antonio.

"If that comes through, I think we will change trauma care during the next 50 years for civilian and military personnel," Holcomb said.

The goal is to "put funds into the hand of researchers," said Sharon Smith, executive director of the National Trauma Institute, a nonprofit organization created in January. The institute is a military and civilian collaboration to target trauma research. It already has received more than $18 million in grant money.

The National Trauma Institute fills a role that currently isn't being funded on a large scale, Smith said. The National Institutes of Health does not have a research institute devoted specifically to trauma, she said.

The institute is focused on funding research, not providing treatment or building a new center. San Antonio already has three level one trauma centers at Lackland AFB's Wilford Hall Medical Center and the Brooke Army Medical Center at Fort Sam Houston. University Hospital's Level 1 trauma center is next door to the University of Texas Health Science Center at San Antonio. It is part of the University Health System, owned by Bexar County taxpayers.

On top of that, Congress this week earmarked $66 million in a 2008 appropriations bill for a new polytrauma center at the Audie Murphy Memorial VA Hospital in San Antonio. That treatment and rehabilitation facility, the fifth of its kind nationally, could be built within two years.

"Not only are we expanding the Department of Defense's health-care missions in San Antonio, but we're expanding the Veterans Affairs funding," Rep. Rodriguez said.

The goal is to provide a seamless transition for injured soldiers leaving the service and then receiving treatment at the polytrauma center, he said.

Within four years, the Brooke Army Medical Center and Wilford Hall Medical Center will combine under the Base Realignment and Closure process to become the San Antonio Military Medicine Center, the largest military trauma research center in the world.

As part of that movement, a new $92 million Joint Center of Excellence for Battlefield Health and Trauma Research to treat soldiers and to train medics is slated for completion by 2009 at Fort Sam Houston.

It's part of more than $2 billion in new construction that will occur in San Antonio under five years of BRAC transition. The process is attracting a lot of local attention.

More than 200 area subcontractors and 20 prime contractors gathered Wednesday at the San Antonio Military Transformation Task Force's daylong meeting at the Joe and Harry Freeman Coliseum. The goal was to link up contractors that might compete for $1 billion in BRAC construction slated for the 2008 fiscal year.

The BRAC work comes as interest in trauma treatment is growing.

The wars in Iraq and Afghanistan have caused more than 20,000 injuries and more than 3,500 deaths to U.S. soldiers, according to H.R. 3673, the legislation to provide the National Trauma Institute's funding.

But trauma is not just a military problem.

"There's 300 deaths from trauma in the United States every day," Smith said.

In the U.S., civilian trauma is the leading cause of death from age 1 to 44. Trauma injuries cost the U.S. $406 billionannually, with $326 billion coming from lost productivity and $80.2 billion from medical treatment.

"This is a rare area where the military is way ahead of industry, technologically," said David Spencer, a member of the state's Emerging Technology Fund's advisory committee, which is looking to invest in the National Trauma Institute.

In a time of war, "the military by necessity" compresses the time it takes to create the next medical devices and treatments, Spencer said.

If approved, the $100 million for the National Trauma Institute would be the largest amount of money put toward injury research in one year, Holcomb said.

"This would change the face of trauma care around the world," he said.

For more on the National Trauma Institute:
http://www.nationaltraumainstitute.org/

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