Treating burns Featured

8:00pm EDT April 25, 2007
The uniqueness of burn injuries and their requisite treatment regimen has created the need for burn specialization units that start patients down the road to recovery quickly and continue the treatment over what is often a lengthy recovery period.

Each year, more than 500,000 people in the U.S. are treated for burn trauma, according to the Web site of the American Burn Association (ABA). Work-related accidents, car crashes and home fires are frequent causes of burns that can result in cosmetic damage, loss of physical function and emotional scarring. More than 60 percent of burn patients are treated in one of the country’s 125 specialized burn treatment centers, according to the ABA.

“Burns are an equal-opportunity offender,” says Dr. Peter Grossman, co-director of the Grossman Burn Center at Western Medical Center Santa Ana. “In a split second, people’s lives are changed. Our goal at the burn center is to return patients to their pre-injury status as quickly as possible and to make certain that the treatment isn’t as bad as or worse than the initial injury itself.”

Smart Business spoke with Grossman about the unique nature of burns, and how Orange County executives benefit from the presence of a specialized burn center.

Why are burns a unique trauma?

First of all, they are a progressive injury. After the initial trauma occurs, the tissue damage can actually worsen over the next few days, so it’s important to take some initial treatment steps and then continue to evaluate the degree of the injury before deciding on a complete course of treatment. Also, the body typically wants to overheal a burn. This overhealing process creates excess scar tissue, so it’s important to begin treatment with a cosmetic outcome in mind and to control how much scar tissue is created in the process.

Second, whether we like it or not, appearance is important in our society and the physical scarring that can accompany a burn can be socially ostracizing for a patient. Burn victims often develop post-traumatic stress disorder and they need support in coping with the fact that they may have experienced a life-changing event.

Third, burn treatment may take years or even decades in order to completely restore function and to reconstruct the affected areas. It is helpful if the patient can stay with the same physician over the course of the entire treatment period.

What is unique about the specialized care in a burn center?

Burns often are treated by general surgeons who are focused on healing the wounds and restoring function. Subsequently, they release the patient to a plastic surgeon for cosmetic restoration. When plastic surgeons see a patient who has been through the functional restoration process independently, our hands often are tied because the damage caused by not incorporating cosmetic restoration with functional restoration has already been done.

When general surgeons remove skin to complete a graft, they often remove the healthy tissue at a deeper level than a plastic surgeon will. This can cause more pain and scarring at the removal site than is necessary and we don’t want to create a wound to heal a wound.

We bring in a psychologist from the onset and we engage multiple specialists as needed, using a team-based approach to the treatment. Our philosophy is to treat the whole patient. We believe that we achieve both better and faster results when the medical professionals approach patient treatment on a cohesive basis.

One of the greatest advances in burn care is not as much technological as it is philosophical. We now know that early removal of the burned skin and covering it with a graft or replacement tissue decreases bacteria and restores healthy blood flow to the area, which increases the positive outcomes. To achieve this, we use an operating room.

Is burn treatment a surgical procedure?

In burn centers, we take a very aggressive approach to treatment. It is more comfortable for the patient to have the burned skin removed under general anesthesia. Because we are a specialized burn center, we don’t have to compete for operating room time and we also find that using a surgical approach actually shortens hospital stays and assists with cost management.

How does having a burn center benefit local businesses and the community?

Because so many burns result from work-related injuries, business professionals can achieve peace of mind knowing that their injured employees will receive state-of-the-art care. Having a specialized local burn center reduces medical costs for employers and it is often a consideration for prospective employees when they think about relocation to the county. Burn centers used to have a reputation as dark and dreary places, now we help patients return as close as possible to their complete pre-injury status as quickly as we can.

DR. PETER GROSSMAN is co-director of the Grossman Burn Center at Western Medical Center Santa Ana. He is certified by the American Board of Plastic Surgery. Reach him at (714) 956-2876. For more information, visit HospitalServices/GrossmanBurnCenter.