U.S. ARMY INSTITUTE OF SURGICAL RESEARCH
"Optimizing Combat Casualty Care"

Brief History of the USAISR


USAISR ORIGINS

The Institute of Surgical Research (USAISR), originally named the Surgical Research Unit, was established in 1943 at Halloran General Hospital, Staten Island, New York.

Its mission was to evaluate the role of newly discovered antibiotics in the treatment of war wounds.

MOVE TO SAN ANTONIO

In 1947, the Institute, with its 12 assigned personnel, moved to Brooke General Hospital, Brooke Army Medical Center, Fort Sam Houston, Texas. At that time, in addition to the study of antibiotics, the Institute was also charged with the study of innovative new surgical techniques and developments.

Then in 1949, due to concern regarding the large number of possible casualties generated by nuclear weapons, the Institute’s mission was further expanded to include the study of thermal injury. The advent of improved grafting procedures and continued use of antibiotics in new applications grew with this mission.

In May 1953, the Institute became a Class II activity of the Surgeon General. It was later assigned to Headquarters, United States Army Medical Research and Development Command in September 1958.

During this period the Institute evaluated forward thinking medical research initiatives, including the use of plasma extenders, grafting and preservation of blood vessels, and the use of an “artificial kidney.”

As the “Army’s Burn Unit,” this unit served as a prototype and model for civilian burn units all over the world and was a premier dialysis research center serving South Central Texas and neighboring states.

BECOMES MRMC SUBORDINATE COMMAND

As part of the Army Medical Department reorganization in March 1994, the Institute became a subordinate command of the Medical Research and Materiel Command, itself a major subordinate command of the newly formed Medical Command (MEDCOM).

In 1996, the Institute moved to its current location adjacent to the newly constructed Brooke Army Medical Center. At this time, the research focus of the mission changed from thermal injury to the full spectrum of combat casualty care.

The Institute of Surgical Research is a highly decorated and celebrated unit. The Institute has been involved in humanitarian missions to foreign countries such as the Union of Soviet Socialist Republics in 1989, Guam in 1997, and Honduras from 1999 to present.

EXPERTISE WIDELY UTILIZED

The Institute has utilized its expertise by caring for burn casualties from every conflict since World War II to Operation Iraqi Freedom and Operation Enduring Freedom, including the 1979 Marine Base fire in Camp Fuji, the 1983 bombing in Beirut, and the 1994 Pope Air Force Base plane crash, as well as dozens of other medical emergencies.

As a result of the 2005 Base Realignment and Closure, in 2010, the combat casualty care research sub-function of Walter Reed Army Institute of Research (from Forest Glen, Maryland) and the Army Medical Research Detachment (from Brooks City-Base, Texas), were co-located and integrated into the USAISR.

In addition, the Army Dental and Trauma Research Detachment from Great Lakes, Illinois, became a subordinate unit of the USAISR.

With the addition of these units, the Institute has grown from a 12 person staff in 1943 to over 700 military and civilian personnel at present. It continues to serve as the primary Combat Casualty Care research facility for the Army.

Moreover, while continuing its excellence in the field of burn care management, the Institute has expanded and placed equal emphasis in providing medical solutions for the injured soldier on the battlefield.

FORMATION OF THE BATTLEFIELD HEALTH & TRAUMA RESEARCH INSTITUTE

Also, as a result of the 2005 Base Realignment and Closure, the Battlefield Health and Trauma Research Institute (BHT) was formed.

This included the construction of a new building adjacent to San Antonio Military Medical Center (SAMMC) and connected to the USAISR building, permitting all Department of Defense (DoD) combat casualty care research (minus neuroprotection) to be co-located with the USAISR. This in turn allowed the following Navy and Air Force activities to be added to the BHT:

• The Naval Medical Research Unit, San Antonio (NAMRU-SA), received the combat casualty and research sub-function of the Naval Medical Research Center from Forest Glen, MD, and the Naval Institute for Dental and Biomedical Research from Great Lakes, IL.

• The United States Air Force Dental Evaluation and Consultation Service (DECS) from Great Lakes, IL.

USAISR Mission & Vision

USAISR MISSION:
Optimizing Combat Casualty Care

 

USAISR VISION:
The Nation’s premiere Tri-Service research organization that integrates safety into planning and executing registry-based and transitional Research providing innovative solutions for burn, trauma, and combat casualty care from time of injury through rehabilitation.

USAISR Info

USAISR Technical Milestones

  • Combat Gauze – 2008 Army Greatest Invention: A large-sized flexible roll of non-woven medical gauze impregnated with a clotting agent known as kaolin. The dressing can be used on surface wounds and has been proposed to treat deep bleeding at the end of a long wound tract.
  • HemCon Chitosan Dressing – 2004 Army Greatest Invention: Made from chitin found in shrimp shells that bonds with blood cells to form a clot. The dressing can withstand blunt force as well as extreme field conditions, including inclement weather,temperature and rugged terrain.
  • Combat Application Tourniquet (CAT) – 2005 Army Greatest Invention: A small lightweight tourniquet that completely occludes arterial blood flow in an extremity. The CAT can be applied with one hand if necessary via a windlass to tighten its strap.
  • Damage Control Resuscitation of Severely Injured Soldiers – 2007 Army Greatest Invention: DCR limits fluid resuscitation, stabilizing the patient's blood pressure to minimize renewed bleeding from recently formed blood clots. Blood volume is restored using plasma along as the primary resuscitation fluid, with packed red blood cells.
  • Flame-Resistant Army Combat Shirt (FR-ACS): Garment reduces the incidence and severity of burn injuries from improvised explosive devices, and helps Soldiers combat heat stress. The unique production process fuses flame-suppressant gas compounds to fibers deep within the shirt’s fabric, increasing fire protection while maintaining comfort and maneuverability.