BUILDING BRAND-NEW SKIN
with the publication of a mandate to focus on readiness,” Cancio said.
In recent years, the Burn Center hosted eight Japanese doctors who have gone on to be prominent burn surgeons and trauma surgeons in their home country, Pruitt said. Two Belgian army surgeons came to study, staying for six months each. Te center also hosted the surgeon general of Norway, he said.
CONCLUSION Pruitt, who retired from the Burn Center as a colonel after 27 years there, still teaches surgery at the Burn Center one day a week. He is particularly interested in the research and clinical studies the center
has expanded into, such as the proper amount of resuscitation (intravenous) fluid for patients, computer-guided resus- citation and the mitigation of inhalation injury. Cancio is active in the management of the inhalation injury and computer- guided resuscitation programs.
During the early parts of the wars in Iraq and Afghanistan, medical staff at the Burn Center noticed some burn patients were receiving too much resuscitation fluid in the first 24 to 48 hours after injury, Cancio said. Te fluid is required to replace ongoing losses to the injured tissue and elsewhere in the body. “Some patients received a quarter of their body weight in saltwater over one day. When this fluid leaks into the arms, legs or abdo- men, too much swelling can cause life- or limb-threatening problems,” he said.
and ’50s, an otherwise healthy adult with burns over 40 percent of his body had a 50-50 chance of surviving. Today, if you have an 80 per- cent burn, you have a 50-50 chance.
“ In the 1940s ” 140 Army AL&T Magazine
To help avoid over-resuscitation and better guide resuscitation decisions, the Burn Center developed a computer called Burn Navigator, manufactured by Arcos Medical Inc. of Houston. “Tis product made it through the Army product acqui- sition process for use in battlefield medical treatment facilities and is also available commercially around the world,” Cancio said.
Combat casualties in the same wars expe- rienced smoke inhalation injury rates that were twice as high as those in civilian burn centers because of the use of improvised explosive devices on personnel in vehi- cles. “To improve the care of patients with these and other severe lung inju- ries, the Army Burn Center became the home of a new program in adult extracor- poreal membrane oxygenation [ECMO],” he said. ECMO uses a pump to circulate blood through an artificial lung, remov- ing carbon dioxide and oxygenating blood cells, which reduces the stress on the patients’ organs and helps them heal.
Cancio is quick to say that much has happened in the years since the publish- ing of the 1970 article and that there are many good burn centers across the coun- try and worldwide; however, “many of the directors of burn centers across the U.S. in fact trained at this burn center throughout the period of time both before and after the article was written, and I think that’s one of the big contributions of this burn center to the quality of burn care. It didn’t just stay at one center, but it extended to other places through the training efforts of our predecessors,” he said.
Pruitt believes the Burn Center has had a demonstrable effect on the survival of many burn patients who otherwise would have died without the advances in clin- ical care and research the Burn Center provided over the years. In conventional warfare, particularly if there are lots of armored fighting vehicles, the number of burns ranges from one in 20 to one in five casualties, Pruitt said. “Tat’s why the Army has a real reason to continue to be the leader in burn and trauma research … the high incidence of burn injury as related to the type of warfare involved is a real reason for maintaining the support of the Institute of Surgical Research and Burn Center.”
For more information, go to http://www.
usaisr.amedd.army.mil/12_burncen- ter.html.
MS. JACQUELINE M. HAMES is a writer and editor with Army AL&T magazine. She holds a B.A. in creative writing from Christopher Newport University. She has more than 10 years of experience writing and editing for the military, with seven of those years spent producing
news and articles for publication. feature
October-December 2018
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