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59th MDW Clinical Research Division

The 59th Clinical Research Division is located at Joint Base San Antonio-Lackland, Texas, and operates in conjunction with Wilford Hall Ambulatory Surgical Center. The 59th CRD is the largest Clinical Investigation Facility in the Air Force Medical Service and is a freestanding facility and vivarium. As the largest Clinical Investigation Program in the AFMS, the 59th CRD supports health sciences education to develop the Military Health Service Force and clinical investigations for the advancement of medical science and its military and nonmilitary application toward patient care. 

The division provides centralized administrative, scientific and regulatory oversight and guidance to the 59th Medical Wing and over 50 other institutions, including Air Force, Army, and Navy sites, universities and civilian research organizations in the development and performance of institutional, national and international biomedical research. The 59th CRD conducts more research and training than all other clinical research facilities in the AFMS combined. Available support includes protocol development, research design, biostatistics consultation, IRB oversight, laboratory analysis, animal surgical services, veterinary care and IACUC oversight. 59th CRD supports operational training requirements for Graduate Medical Education programs and wing healthcare providers.

The 59th CRD supports many areas of clinical investigation with special concentrations in:

  • Vascular Research
  • Medical Toxicology
  • Emergency Medicine
  • Regenerative Medicine
  • Stem Cell Research
  • Dental Post Graduate Research

​The 59th CRD provides unique medical readiness training (375 Training classes, Over 1,800 students trained in fiscal year 2013.

  • General Surgical Skills Training
  • Extracorporeal Membrane Oxygenation (ECMO) Training
  • Pararescue Technique Training
  • Emergency Skills Training
  • Emergency War Surgery Course
  • Oral Maxillofacial Training
  • Endovascular Skills Training and Resuscitative Surgery (ESTARS)
  • Urological Surgical Skills Training
  • Plastic Surgical Microvascular Surgery Training
  • MicroSurgical Training for Ophthalmology Residents
  • Divinci Surgical Robot Training 

The 59th CRD is divided into three branches:

Support Branch

The Support Branch ensures 59th Medical Wing maintains all appropriate federal and DoD assurances to perform human subject research, appropriate inter-institutional agreements for collaborative research locally, nationally as well as internationally and assists visiting investigators in being covered by the 59th MDW assurances when appropriate.

The Support Branch supports the Institutional Review Board and Institutional Animal Care and Use Committee which provide IRB regulatory oversight, outreach, and training while ensuring regulatory compliance for all 59th MDW human research and research studies currently active in over 25 other institutions, including Air Force, Army, and Navy Medical Treatment Facilities, universities and civilian research organizations; IACUC regulatory oversight/ensures regulatory compliance for all animal studies conducted by the 59th MDW, respectively. The Support Branch also assists investigators with protocol development, approval of clinical investigations, biostatistics, and dissemination of findings. The support branch is the primary office for training and issues dealing with IRBNET, our new web based protocol management system.

  • In FY15, over 400 clinical studies conducted throughout the AFMS were managed by 59th CRD Protocol Office
  • 362 of the clinical investigation protocols were human and human exempt studies
  • 55 animal clinical investigation and training protocols were conducted in FY13
  • Residents served as Principal or Associate Investigator’s for the majority of these studies
  • 59th CRD manages oversight of human and animal studies through the Institutional Review Board and Institutional Animal Care and Use Committee
  • 59 MDW IRB have agreements in place to serve as primary IRB for 52 other institutions, including Air Force, Army, and Navy Medical Treatment Facilities, universities and civilian research organizations

Operations Branch

The Operations Branch provides comprehensive animal care, surgical support and animal pathology services:

  • Three fully functioning operating suites, including microsurgical capability
  • One animal hyperbaric/hypobaric chamber for clinical investigation such as altitude sickness, hyperbaric treatment of radiation injury, and wound healing
  • Two Instron Materials Testers for various applications to determine fatigue, impact, and/or resistance of materials and tissues
  • Radiology and imaging capabilities, including ultrasound, digital film, and fluoroscopy
  • 25,000 square foot facility which houses up to seven species of animals
  • Approximately 40,000 square feet of paddock area for up to 250 animals
  • A fully equipped necropsy room (area for performing complete animal post-mortems)
  • Animal histopathology laboratory for preparing slides of collected samples for examination by a veterinary pathologist including gross and microscopic pathology analyses of tissues, lesions, bones, teeth, and metal prostheses
  • DiVinci Robotic Surgery System – training program to certify surgeons to use the system in actual patient surgery
  • Over $17M in medical equipment available to support clinical investigations

Laboratory Branch 

The Laboratory Branch provides human & animal laboratory support in five major areas:

Chemistry and Toxicology: Clinical Chemistry, Spectrometry, High Performance Liquid Chromatography, state of the art Gas Chromatographic-Mass Spectrometric (GS-MS) and Liquid Chromatographic Mass Spectrometric (LC/MS/MS) instruments for the analysis of drugs, drug metabolites, hormones, enzyme inhibitors; identification of biomarkers for disease prediction, treatment monitoring, and other small molecular weight compounds

Hematology: CBC, platelet, reticulocyte and differential, coagulation testing (clottable, chromogenic, and latex immunoassay), platelet function, and enzyme immunoassays

Molecular Biology: Real-time polymerase chain reaction (PCR) and multiple sequencing techniques to include Pyrosequencing, Sanger sequencing and Next generation sequencing for nucleic acid detection, typing, and gene expression

Cell Biology and Immunology: Multicolor flow cytometry to quantify and measure specific cells, cell culture capability to include proliferation and viability studies, single and multiplex biomarker detection and quantification with enzyme-linked immunosorbent assay (ELISA), and Blood Banking

Microbiology: Aerobic and anaerobic culture for epidemiology, disinfectant, proteomic, and medical readiness studies, Microscopy to include General, Fluorescent and Scanning Electron Microscope with 3D Dimensional capability