Clinical sciences

As part of research to prevent surgical infection, MQ Health researchers have demonstrated the prevalence of bacterial biofilms on surfaces and their role in causing surgical and other hospital-acquired infections.

Biofilms are extended colonies of bacteria that develop on surfaces. The colonies are protected by a self-generated layer of biological molecules, the ‘biofilm’, and so are difficult to remove or kill with disinfectant. Moreover, the bacteria can survive within the biofilm for extended periods and consequently can remain an ongoing source of possible infection.

Research within MQ Health is exploring ways to remove biofilms and minimise their (re-)development. Studies of the biology and chemistry of biofilms, and the bacteria that live within them, are helping identify and test better ways to sterilise surfaces.

Other research is examining the effects of bacterial biofilms in wounds, breast implants, cystic fibrosis, orthopaedic plates and the dental environment.

This work has already allowed development of new strategies to minimise the risk of biofilm-associated capsular contraction in breast implants. These strategies are used as standard practice by MQ Health’s Plastic and Reconstructive Surgery Clinic.

Biomechanics is the study of how the human body moves. It is a substantial area of clinical research activity for MQ Health. Studies usually combine experimental measurements with computational simulations to bring new insights into normal function of joints such as the knees, hips and shoulders, but also into joint problems and the best use of orthopaedic implants when joint replacement is needed.

For example, some of our biomechanics researchers are developing new evidence-based approaches, often drawing on the rich data streams available through ‘wearable technologies’, to improve military training and sports training. These projects are identifying better ways to build fitness, strength and technique while reducing the risk of injury, for everyone from members of the armed forces and elite athletes to amateur sportspeople.

Other research is examining how to ensure that older Australians with joint pain and mobility problems receive evidence-based rehabilitation and care to help them avoid unnecessary or premature surgical joint replacement (arthroplasty).

When arthroplasty is required, our researchers are exploring better approaches to precisely measure how individuals’ joints move in order to reduce the incidence of implant problems or failure down the track. We are developing improved methods to tailor selection of implants for each patient, as well as to allow more precise surgical pre-planning and therefore optimal positioning of the implants during surgery. These studies take advantage of the experimental capabilities of our Surgical Skills Centre and Macquarie University’s Simulation Hub, and combine the resulting data with biomechanical simulations of joints and motion and load distributions.

The vast majority of Australians will experience an episode of lower back pain at some point during their lives, but when it recurs it can become a chronic and debilitating condition. Over 10% of Australians live with chronic back pain, yet little is understood about the underlying causes of this complex condition.

MQ Health has a substantial research effort to better understand the causes, diagnosis, treatment and prevention of recurrent back pain.

For example, our researchers are leading, or contributing to, a number of studies and trials to assess risk factors for lower back pain, and which types of existing and new management approaches can reduce back pain and minimise the risk of recurrence.

They are also studying the use of medical imaging to diagnose causes of back pain, or to determine the likely prognosis of patients and the best treatment approach. This remains an under-explored area of research in modern medicine, despite the value of medical imaging for other conditions and diseases.

Further pain-related research within MQ Health is working towards a better understanding of, and new treatment options for, other forms of chronic pain, such as that caused by knee osteoarthritis, sciatica, neck injuries and other types of trauma.

This research focuses on improving recovery of patients after stroke or other acquired brain injury, by maximising appropriate physical activity in patients on a long-term basis.

Sustainable physical activity has been shown to deliver the greatest recovery and to reduce the risk of other complications or health issues arising from reduced exercise and activity.

Projects in this area involve developing and validating evidence-based programs to facilitate patients’ self-management of their physical activity, and to reduce the risk of other problems, such as falls caused by impaired balance and coordination.

Beyond the biomechanics-related research to improve the approaches for orthopaedic surgery, or new approaches for cancer surgeries or neurosurgery, MQ Health conducts other research to advance surgical techniques.

One such area is in cardiothoracic surgery and development of evidence-based surgical approaches to improve patient experience and outcomes after major heart surgery, such as aortic arch surgery. Other efforts are seeking to test and develop a solid evidence base for minimally invasive techniques for cardiac, lung and gastrointestinal surgeries. Often the end goal of this work is the development of national or global surgical databases and protocols for best-practice, evidence-based treatment.

Other innovations are occurring in the development of new devices, instruments and technologies that can support more precise and safer surgical approaches.

To underpin all of this activity, collaborative research with the Department of Philosophy is developing a practical framework to better manage the ethical and regulatory issues associate with surgical innovation in the healthcare system.