Abstracts / Injury, Int. J. Care Injured 40S (2009) S1–S26S14

findings and the osteoinductive potential of serum from traumaticbrain injured (TBI) patients, and to identify putative osteoinductivefactors.

Methods: Serum and CSF samples were collected from 17 TBIpatients with a concomitant femur shaft fracture and from 24control patients reporting an isolated fracture. On admission allpatients were evaluated using the Glasgow Coma Scale (GCS).Standardised X-rays of the fracture were taken on admission andpost-surgery, at 6 weeks, 3, 6 and 12 months. Time to union wasdetermined, the callus size measured and its ratio to the shaftdiameter calculated. The osteoinductive potential was determinedby measuring the in vitro proliferation rate of the human fetalosteoblastic cell line (hFOB 1.19). Subsequently the samples wereprocessed and analysed using a novel proteomic approach,including enrichment of the unknown factor and 2D electrophor-esis.

Results: TBI patients had a shorter time to union (p < 0.001) andshowed an increased callus formation in both X-ray projections(p < 0.001). TBI specimens induced a higher mean proliferationrate in hFOB cells (p = 0.014). Statistical analysis revealed acorrelation between proliferation rates and callus formation(p < 0.05). A negative correlation between proliferation ratesand time to union was also evident (p < 0.01). Pearsons’ correlationcoefficient demonstrated significant relationships between GCSscore, mean callus ratio and proliferation rates. First proteomicresults showed clear cut differences on corresponding 2D gelsbetween TBI and control samples. Most important, several proteinspots were exclusively present on the 2D gels from TBI patients.

Conclusions: This study demonstrates firstly an enhancedfracture healing and callus formation in TBI patients in comparisonto patients without TBI and similar fractures, indicating that thetraumatic injured brain might release osteoinductive factors.Secondly, there is a strong correlation between the clinicaloutcome and serum related induction of proliferation of osteo-blastic cells in vitro, indicating that the osteoinductive factor isreleased into the systemic blood circulation by the injured brain.

doi: 10.1016/j.injury.2009.01.061

ORAL–INVITED

BREAKOUT 7-2

Clinical practice guidelines

A. Delprado

Careflight, Westmead, NSW 2145, Australia

In the era of evidence-based medicine the ability to move theevidence from the literature to application in clinical practice isproving to be challenging at times. The introduction of evidence-based clinical practice guidelines (CPGs) within trauma carecontinues to grow. Evidence from other specialties shows as littleas 3–10% uptake by clinicians of CPGs in practice. How do weensure that these CPGs are actually used by clinicians in their dailypractice? What makes a CPG successful? How do we engage andget ‘‘buy in’’ from the clinicians and therefore translation ofevidence into practice via CPGs? Lessons learnt from theexperience gained during the development and introduction ofthe Institute of Trauma and Injury Management (NSW ITIM)trauma clinical practice guidelines will be discussed in thispresentation.

doi: 10.1016/j.injury.2009.01.062

ORAL–INVITED

BREAKOUT 7-3

Translating research into practice: The role of the CochraneCollaboration

S. Green

Australasian Cochrane Centre, Clayton, VIC 3168, Australia

Effective translation of research into practice relies on fourplatforms:

1. K

nowledge generation and synthesis to improve access torelevant reliable research.

2. U

nderstanding of current patterns of care and health policyincluding identification and description of areas of practice notaligned to current research.

3. T

he development and testing of strategies to bring aboutpractice change and the uptake of research into practice.

4. B

uilding infrastructure and workforce capacity for research use.

The Cochrane Collaboration is an international organizationwhich aims to inform healthcare decisions through preparingreliable systematic reviews of healthcare interventions, andensuring they are relevant and accessible. This provides the firstof the four platforms listed above. This presentation will introducethese concepts, explore some current initiatives to make Cochranereviews more useful, and more used, and present some strategicoptions for building knowledge transfer and exchange in traumacare.

doi: 10.1016/j.injury.2009.01.063

ORAL–INVITED

BREAKOUT 8-1

Tissue engineering for repair and regeneration of new tissue

W. Morrison

Bernard O’Brien Institute of Microsurgery and St Vincent’s Hospital,

Fitzroy, VIC 3065, Australia

We have developed an in vivo model of tissue engineering,which comprises a non-collapsible chamber and a vascular pedicle.This environment induces an intense angiogenic response andwhen cells and or matrix materials are seeded into the chamber,they can survive and organise into a specific tissue type. We havesuccessfully induced large volumes of fat to grow as well as muscle,bone, cartilage and organ tissue including heart, pancreas andthymus.

doi: 10.1016/j.injury.2009.01.064

ORAL–INVITED

BREAKOUT 8-2

Presenter absent – No Abstract

doi: 10.1016/j.injury.2009.01.065