Dr. Joachin Kohn, Director of the AFIRM’s Rutgers-Cleveland cohort, demonstrates the flexibility of one AFIRM development, a material designed to withstand bending while protecting connected nerve sections as they regrow.

The AFIRM has also been working on a flexible material that can help reconstruct nerves that have been damaged or severed. The braided material prevents any kinking that could kill the nerve while it heals and reabsorbs into the body once the work is complete. They are also developing ways to regrow nerves faster and protect existing nerve endings to help prevent muscle atrophy in patients waiting for that replacement.

This is just a brief accounting of the many advances this team has developed in its short existence.

“The AFIRM is in its fifth year, but remember it takes one year to start something up,” explained Kohn. “So for just four years of work from the AFIRM, this is unprecedented progress. If you expect magic, it won’t work. But the progress has been fantastic. You have to give medical device development seven-to ten-year, but even then we’re faster than any time in the past.”

The Future of the AFIRM

When the AFIRM was first launched, it was tasked with finding treatments for serious burn trauma caused by explosive devices in Iraq and Afghanistan. While that is not the primary concern today, the AFIRM continues this work for the next cycle.

“If or when the insurgents change their strategy, we will see burns again, and we will be ready,” said Kohn. In the meantime, now in transition between the first and second five-year cycles, the AFIRM is in a crucial position.

One could look at this story and view it through a skeptic’s glasses. After all, many of the treatments the AFIRM is working on are still in clinical trials, and they have yet to put a product on the market.

“The skeptic would say nothing has changed, and that’s a valid point,” said Dr. Kohn. “The reason for this is medical-device development’s extraordinarily long cycle. The first artificial skin was invented at MIT in 1976, and it was first approved as a product by the FDA in 1996. That’s a 20-year cycle.”

By these standards, the breakthroughs of the AFIRM won’t be in practice until 2028. However, a greater utility of the technology paired with an understanding of how to navigate regulatory pathways and finance such innovation is significantly shortening that timeline.

“We are seeing medical-device development cycles as short as five to eight years now,” said Kohn. “And I am privileged to see what is in the pipeline for five years from now. That’s the part that the skeptic doesn’t see, and there will be massive changes.”

One person who is not skeptical is Todd Nelson. For someone who will likely not benefit personally from the advances, he has high praise for the work of the AFIRM. He also encourages other veterans, especially those who have suffered traumatic injuries and long recoveries, to get involved in the discussion about the AFIRM through social media.

“I’m really excited about the potential the AFIRM has because it’s really earth-shattering stuff,” said Nelson. “If there are any other disabled veterans out there that want to be part of it, here’s a chance to be part of something significant. If you’ve ever wondered why did this happen to me, it might be because you’re the building block to helping someone else. This will go down in the history books; it’s a chance to be part of something great.”

To learn more about the AFIRM or to become part of the conversation on Facebook, visit www.facebook.com/AFIRM.MRMC.

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