Clinical Research Directory

Botulinum Toxin Type A Versus Local Anesthetic Injection for Chronic Neuroma Pain After Combat-Related Amputation

Patients with combat-related amputations frequently experience persistent neuroma pain that may interfere with rehabilitation, prosthesis use, sleep, mobility, and quality of life. Current treatment options often provide only temporary relief. This study aims to compare two ultrasound-guided injection approaches for chronic neuroma pain after combat-related amputation: botulinum toxin type A and local anesthetic injection. Participants will be randomly assigned to receive one of the two treatments. Pain intensity, neuropathic pain symptoms, phantom limb pain, prosthesis tolerance, and functional outcomes will be evaluated during follow-up visits over a 24-week period. The goal of the study is to determine whether botulinum toxin type A provides longer-lasting pain reduction and improved functional recovery compared with local anesthetic injection in patients with chronic neuroma pain after combat-related amputation.

Blast-related Regional Anaesthesia and Peripheral nerVe Injury Evaluation

This randomized study will examine whether ultrasound-guided regional anaesthesia (a nerve block) contributes to new or worsening peripheral nerve problems after blast-related limb trauma. Blast injuries themselves can damage nerves, making it difficult to determine whether later numbness, weakness, or neuropathic pain is caused by the injury, surgery, or the nerve block. Adults with blast-related upper- or lower-limb trauma who need pain treatment will be randomly assigned to one of two standard pain-management strategies: regional anaesthesia plus multimodal analgesia, or multimodal systemic analgesia without a planned nerve block. All participants will receive appropriate rescue pain treatment if needed. Neurological function will be documented before treatment and reassessed during hospital care and follow-up. The main outcome is a new or worsened peripheral nerve deficit 30 days after treatment. The study will also assess pain relief, opioid use, function, neuropathic pain, and safety events up to 6 months.

DRONE-WOUND Study: Severe Infection After Drone-Related Combat Trauma

Drone-related combat injuries have become one of the most devastating mechanisms of injury in modern warfare. These injuries often cause extensive tissue devitalization, contamination, open fractures, vascular injuries, and complex soft tissue damage, which may substantially increase the risk of severe wound infection, multidrug-resistant bacterial infection, repeated surgical procedures, limb loss, and sepsis. However, the relationship between the extent of tissue devitalization and the development of severe infection has not been systematically investigated. The DRONE-WOUND Study is a prospective observational cohort study designed to evaluate the association between tissue devitalization and severe wound infection in patients with drone-related combat trauma. The study will collect detailed clinical, surgical, microbiological, and radiological data from injured patients treated at participating trauma centers. Measures of tissue injury, contamination, surgical management, microbiological findings, and infection outcomes will be analyzed to identify factors associated with severe infection and poor clinical outcomes. The findings of this study are expected to improve understanding of the mechanisms leading to infection after drone-related injuries, support early identification of high-risk patients, and inform future strategies for surgical management, antimicrobial therapy, and infection prevention in combat trauma. Ultimately, the study aims to improve limb salvage, reduce infectious complications, and enhance outcomes for patients with severe drone-related injuries.