Surgical residents honored for trauma research

Two University of Florida College of Medicine surgical residents recently swept a state trauma research competition with wins in both the basic and clinical science categories. The UF honors extended to the regional level in November with a win in the clinical science category at an American College of Surgeons’ competition.

Robert Winfield, M.D., a third-year clinical resident, won both the Florida State Committee on Trauma and the American College of Surgeons’ Committee on Trauma Region IV resident competitions for his clinical research work in the area of trauma’s impact on morbidly obese patients.

Winfield, who took two years out from his clinical residency training to focus on research, found that morbidly obese people involved in major trauma do not respond the same way to traditional resuscitative measures, such as intravenous fluids, as people of normal weight do, and that this response can be associated with the development of multiple organ failure.

“Our identification of a differential response to traditional resuscitative practices carries profound implications for the care of these patients following traumatic injury,” said Winfield, who added the next steps will be to evaluate amounts and types of fluids provided to patients and assess how they are monitored, and to look at other variables that may play a role in the development of multiple organ failure in obese patients.

Elizabeth Warner, M.D., currently in her second year of research as part of her surgical residency training, found that neutrophils, a type of white blood cell that migrates to the lungs of patients with acute respiratory distress syndrome, or ARDS, have very different patterns of gene expression than neutrophils found in the same person’s circulatory system.

“These findings will help the scientific community to understand the mechanisms that drive the inflammation and progression of ARDS, which can lead to the development of new drug and gene therapies that might one day improve the survival of these patients,” said Warner, who will return to her clinical training next fall. She added that further research could potentially identify a specific gene expression pattern associated with the syndrome that may help surgeons determine how patients will respond after surgery.

Both Winfield and Warner conducted their research in the UF department of surgery’s Inflammation Biology and Surgical Science laboratory, headed by Lyle L. Moldawer, Ph.D., the department’s vice chair of research. UF offers surgical residents an opportunity to spend one or two years in a laboratory conducting research. Traditionally this opportunity is available to any of the five residents in each training class who have the interest.

Winfield’s research was supported by a combination of departmental funding, funding from the National Institute of General Medical Sciences, and a training grant from the National Cancer Institute. Warner’s research was supported with UF general surgery research funding, and funding from the National Institute of General Medical Sciences. Both received the Quillian H. Jones Jr. Award plaque, along with a monetary award, at the state competition.

Winfield’s research will now be considered for national presentation at the American College of Surgeons’ Committee on Trauma annual meeting. He will find out this winter if he has been selected.

Lawrence Lottenberg, M.D., a UF associate professor of surgery and trauma medical director, said he is very proud of the accomplishments of Drs. Winfield and Warner, and that their outstanding research has been recognized at the state, regional and national levels.

“The University of Florida acute care surgery division within the department of surgery is training the true ‘triple talent surgeon’; clinical, education and research,” said Lottenberg.