As the medical director of trauma clinical research, Martin D. Zielinski, M.D., studies methods of improving outcomes in injured and acute surgical patients. To this end, Dr. Zielinski has multiple active projects in the realms of acute general surgery and trauma. Specifically, he studies blood product transfusion for injured patients, the appropriate management of small bowel obstruction and improving the closure rates of patients who have damage control laparotomies after major abdominal operations.

Dr. Zielinski's team consists of research fellows and staff who perform chart review studies as well as prospective clinical trials. His ultimate goal is to have the nation's first warm, fresh whole blood transfusion program for hemorrhaging patients.

Focus areas

• New transfusion paradigms in hemorrhage. Hemorrhage is the most common cause of preventable death in trauma patients. While a transfusion paradigm using warm, fresh whole blood is Dr. Zielinski's long-term goal, it is necessary to develop intermediate steps. Dr. Zielinski studies the effect that group A plasma as the universal donor, rather than AB, has on outcomes. In addition, he is defining what constitutes "overtransfusion" in an effort to reduce blood product-associated complications, including acute lung injury.
• Small bowel obstruction. One of the most common surgical diseases, small bowel obstruction can be treated nonoperatively or operatively, but it can be difficult to determine which course is best. To assist clinicians, Dr. Zielinski has developed a model that predicts the need for exploration. In addition, he is actively studying the effects that oral contrast agents, such as Gastrografin, have on the diagnosis and treatment of small bowel obstruction.
• Damage control laparotomy. Damage control laparotomies are major abdominal procedures that must be abbreviated due to critical illness. Sixty percent of these patients will never have their abdominal wall closed and are at subsequent risk of severe complications as well as later reconstructive surgery. Dr. Zielinski is the principal investigator for a multicenter, randomized, placebo-controlled clinical trial studying the effects that botulinum toxin (Botox), a flaccid paralytic, has on the ability to close the abdominal wall.

Significance to patient care

Dr. Zielinski has a focus on clinical research in all of his studies. His intellectual curiosity aims to ensure that practices will change for the better in each study he performs. This was the driving force behind the development of the small bowel obstruction model as well as design of his damage control laparotomy clinical trial.

In addition, with further research in hemorrhage resuscitation, he believes that more lives can be saved through the use of new blood transfusion paradigms.