Medical research charity, The Scar Free Foundation, announced its key research priorities to achieve scar free healing within a generation for survivors of conflict wounds. The research priorities encompass three main themes: acute wound care and diagnosis; the biology of scarring; and life-long scar impact, revision and rehabilitation. The Foundation is also launching a call for applications to conduct pilot studies which address these vital areas.

As part of The Foundation’s grant from the Chancellor using LIBOR funds to establish The Scar Free Foundation Centre for Conflict Wound Research, the world’s first specialist military and civilian conflict wound research centre, an initial £150,000 is available to support pilot or feasibility studies, which have the potential to be developed into larger-scale research programmes with higher awards from the Foundation and other funders.

Scarring can have a significant long-term physical and psychological impact on survivors of conflict. More than 6,000 members of the British armed forces have been seriously injured or scarred in recent conflicts*. It is anticipated that future conflicts will be conducted in unpredictable, potentially austere and heavily contested spaces and are expected to involve more lengthy evacuations than those experienced in Iraq and Afghanistan. In addition to gun shot and blast injuries seen in combat, it is likely that the emergence of new weapons, such as thermobaric weapons, will result in far more burns casualties.

The research priorities are the result of the Foundation’s Conflict Wound Research Symposium, held at The Scar Free Foundation Centre for Conflict Wound Research, a ground-breaking national facility based at Queen Elizabeth Hospital in Birmingham. The symposium took place in May and was attended by 84 researchers, clinicians, military veterans from the CASEVAC Club and senior armed forces personnel from the UK and the USA, along with representatives from military support charities.

The centre’s main aim is to minimise the psychological and physical impact of scarring and limb loss among armed forces personnel injured in service and civilians wounded in terrorist attacks, and the work carried out is actively supported by senior armed forces personnel including the Chief of the Defence Staff, Chief of Defence People and the Surgeon General. The research undertaken at the Centre is part of the Foundation’s longer term strategy to achieve scar free healing within a generation.

Applicants will be asked to submit projects of up to 12 months in length. The Foundation’s intention is to fund up to three projects of up to £50,000, however if a larger project is submitted of sufficient merit which ‘cross cuts’ several of the priority areas, it is possible a larger funding request will be considered. Applicants will be asked to send project outlines (a one-page summary for discussion and recommendation), prior to submitting a full application.

Brendan Eley, Chief Executive of the Scar Free Foundation, said: “To ensure our work is at the forefront of scarring research, it’s crucial that we collaborate with a wide network of academic researchers, clinicians, military veterans and serving personnel to establish the future needs of those surviving conflict wounds – both in military and civilian scenarios. Scarring not only has a lasting physical effect, but can have a serious impact on survivors’ mental health long after the wounds themselves have healed. We welcome applications for pilot studies to help us take the next step in our journey to deliver scar free healing within a generation.”

Dave Henson, Co-Founder of The CASEVAC Club said: “The membership of the CASEVAC Club is comprised of unexpected survivors – those that, by right, should have died on the battlefield. For many, surviving wounds of their severity is unheard of and new to medical science. We are actively engaging with this research because the knowledge that can be gained will provide insights that can increase the likelihood of more unexpected survivals in the future, and improve the outcome for survivors of traumatic injury in general.” 

Research Priorities:

Theme 1:       Acute wound care and diagnosis (development of therapies and diagnostic tools that are appropriate for treating acute injuries sustained in austere conflict environments, where risks of contamination, extremes of temperature, and transportability are all factors.)

  1. What tools or protocols could be developed to assist the objective assessment, rapid diagnosis and categorisation of conflict wounds?
  2. What steps can be taken to mitigate secondary injury prior to casualty recovery from conflict zones, for example tools to aid the detection of sepsis?
  3. What treatments, such as ‘anti-scarring’ wound dressings, should be developed for use in austere conflict and humanitarian environments?
  4. Considering the possible nature and environment of future conflicts, which models would best inform acute wound care research?

Theme 2:       The biology of scarring (to better inform new treatments by understanding how the body heals and protects itself following the types of trauma that are likely in future conflicts, including chemical, burn, and complex blast injury.)

  1. What is the best suite of models to investigate high energy complex injuries?
  2. What can we learn from other fields either for therapeutics or the understanding/monitoring of biology, for example imaging and bioengineering?
  1. What work should be undertaken to develop our understanding of the wound bio-membrane?
  2. How can we understand the long-term effects of relevant injuries for example accelerated ageing and the influence of psychology on biology?

Theme 3:       Life-long scar impact, revision and rehabilitation (improvement of therapies for seriously injured armed forces personnel and veterans to reduce and correct scars, and to promote resilience to the psychological impact of their disfiguring injuries.)

  1. How do we ensure the best psychosocial outcomes for military personnel with conflict injuries that have altered their appearance, and their families?
  2. What is the physiological, life-long impact of limb amputation and prosthetic use?
  3. What is the role of physiotherapy and other treatments such as laser therapy in breaking down disabling, internal scar tissue and supporting return to function?

* There were 838 Seriously or Very Seriously Injured or Wounded battlefield casualties recorded by NOTICAS from 2001-2014 across Operations TELIC (Iraq) and HERRICK (Afghanistan), and 6,326 Veterans received compensation between 6 April 2005 to 31 March 2017 through the Armed Forces Compensation Scheme due to Injury, Wounds and Scarring.

About The Scar Free Foundation (www.scarfree.org.uk)

The Scar Free Foundation is a medical research charity, chaired by Professor Sir Bruce Keogh (former National Medical Director of NHS England), whose mission is to achieve scar free healing within a generation and transform the lives of those affected by disfiguring conditions. Founded in 1999 as the Healing Foundation, it has supported over £20 million of life changing research into wound healing and reconstructive surgery.

The Scar Free Foundation Centre for Conflict Wound Research forms part of the Foundation’s national, Scar Free Strategy aimed at delivering new scar free treatments within a generation.

About The Scar Free Foundation Centre for Conflict Wound Research

The Scar Free Foundation Centre for Conflict Wound Research has been established in partnership with the University of Birmingham, University Hospitals Birmingham NHS Foundation Trust, the Centre for Appearance Research at the University of the West of England, and The CASEVAC Club. Crucially, the centre is closely integrated with a wider network of academic and clinical institutions in the UK and beyond to ensure that the work is inclusive and at the forefront of scarring research.

Research undertaken at The Scar Free Foundation centre will cost £4.8 million over three years. This is being funded by the Chancellor using LIBOR funds of £3 million – the largest grant announced in the final round of LIBOR funding – alongside an additional £1.8 million from the Foundation’s partners, including the Ana Leaf Foundation and JP Moulton Charitable Foundation.

About the CASEVAC Club

The CASEVAC Club is an organisation set up by and for armed forces personnel wounded in recent conflicts. The Club, based on WW2’s The Guinea Pig Club, aims to assist in the advancement of medical science and treatments for all, help others experiencing traumatic injury and provide wounded personnel with a close-knit community.  Members of the CASEVAC Club are working closely with The Scar Free Foundation Centre for Conflict Wound Research.