Ohio State’s Military Medicine Program provides holistic treatment for combat-wounded veterans

MilitaryMedicalProgramImage above: Dr. Jason Souza examines Nick Vogt at The Ohio State University Wexner Medical Center to assess his recovery after surgery. Vogt lost both legs after being injured in the war in Afghanistan, and Souza was able to graft skin, fat and blood vessels to provide padding that allows him to sit upright for extended periods of time without pain.

U.S. Army Capt. Nick Vogt was leading a platoon in Afghanistan when they discovered a weapons cache in 2011. As they were investigating, two improvised explosive devices (IEDs) detonated, one of which wounded Vogt. He and another soldier sustained most of the blast.

The explosion left Vogt with multiple injuries including a traumatic brain injury and severe tissue damage that required the amputation of both legs at his hips. Spc. Calvin Peretta later died from his injuries.

“I was getting all the sensations, the pain, also the numbness, because when I'm sitting, it actually cuts off the circulation for the few vessels that I had left there,” said Vogt, who grew up in north central Ohio.

Years later, even after a lengthy recovery with many complications, he couldn’t sit upright for more than a few minutes at a time. He was unable to comfortably use a wheelchair or prosthetics.

“I couldn’t even enjoy a meal with my family without having to lay on my side because there was just skin on bone under my pelvis, which easily degrades and is very painful,” Vogt said.

But the new Military Medicine Program at The Ohio State University Wexner Medical Center focuses on helping veterans like Vogt and is already making difference.

MilitaryMedicalProgram-familyImage above: Nick Vogt lost both of legs after being injured by an IED while deployed with the U.S. Army in Afghanistan. Vogt is now able to sit upright and spend time with his wife, Lauren, and their two children after an innovative surgery to graft skin and fat to provide padding and prevent tissue degradation.

The program uses cutting-edge technology performed by a team of reconstructive surgeons, peripheral nerve surgeons, microsurgeons, neuroplastic and orthoplastic surgeons paired with rehabilitation experts and other multidisciplinary specialists working together to provide individualized care. The program has success at relieving nerve pain through innovative reconstruction and rewiring of nerves.

Jason Souza, MD, director of the Orthoplastic Reconstruction Program and associate professor in plastic and orthopedic surgery at the Ohio State Wexner Medical Center, performed a 12-hour surgery that changed Vogt’s life.

“No injury is the same, so we have to think creatively to come up with solutions that will work for each patient, and that’s how we continue to expand our capabilities,” Souza said.

Before the surgery, Vogt said, “Lauren and I, my wife, we had been through a lot of just frustration with the inabilities for me on sitting. The time spans were frustrating, especially once we had kids.”

Now Vogt has a more active life with his family.

“Dr. Souza was able to take a flap of skin from my back, along with layers of fat and the vessels underneath, and put that under my pelvis where I needed the padding,” Vogt said.Vogt isn’t alone. There are more than 660,000 veterans in Ohio, making it one of the nation’s largest veteran communities.

“Technology and techniques that were born out of the last two decades of military conflict have been widely applied to cancer and civilian trauma care. The Ohio State University is well positioned to return the favor, by offering these veterans state-of-the-art care,” Souza said.

Due to advancements in body armor, there is a higher survival rate for soldiers in combat who often came home with numerous traumatic injuries. Many have suffered severe injuries from IEDs that shatter bones, shred limbs and damage muscles and nerves.

“In the military, they had advances in armor that protect the core and the head. And so we had the highest survival rates during (the War in Afghanistan), but also the largest amount of large limb amputations,” said Amy Moore, MD, chair of the Department of Plastic and Reconstructive Surgery at the Ohio State Wexner Medical Center and a peripheral nerve surgeon.

Learn more about how Amy Moore, MD is helping repair nerve damage by rewiring human nerves

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Survivors often require a lifetime of physical and mental care that requires a multi-faceted approach.

Post-surgical recovery for patients like Vogt is tailored to meet individual care needs, such as amputee rehabilitation, neurological rehabilitation, physical therapy of lower and upper extremities and specialty hand therapy. Individual and group counseling is also made available for veterans.

“We look at what tissue we have to work with, how we can leverage technology to fill some of the gaps and how to think beyond just putting back what's been lost to restore function,” said Souza, a Navy physician who was recruited from Walter Reed National Medical Center in Bethesda, Maryland.

Grants from the Department of Defense and other federal agencies are enhancing the military medicine program and research efforts.

Moore said doctors developed a new procedure to improve prosthetics by anchoring them into the bone rather than bearing weight on a socket. These types of advancements reduce chronic pain, increase mobility and improve the lives of combat-wounded veterans.

“We move from that survival, which is in the acute time of their injury, to the rest of their lives. And that's where we here at Ohio State can intervene, and improve in their quality of life and giving them back their joy,” she said. “We can provide the multidisciplinary expertise that is required to care for these patients whether it’s orthopedic, plastic surgery, urology, etc. We have it here at Ohio State, and we’re going to build upon it.”

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