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To deal with the many consequences of severe burns, a growing
number of major hospitals have established burn centers, staffed
by the medical equivalent of police swat teams, that accommodate
every need of critically injured burn victims. America's busiest
burn unit is at Manhattan's New York Hospital-Cornell Medical
Center and consists of some 100 doctors, nurses, therapists,
social workers and dieticians who treat 1,300 patients a year in
the unit's 46-bed facility. "The name of the game in burns is
teamwork," says Dr. Roger Yurt, the unit's director since 1995.
Yurt, 52, began specializing in burn treatment while he was a
doctor in the U.S. Army. Since he took over the burn unit, he
has expanded the team to include highly specialized nurses and
even a chaplain, who ministers not only to patients and their
families but also to staff members, who are exposed daily to
unnerving sights and suffering.
A few team members are particularly motivated by the fact that
they too were once burn victims. Others, like Dr. Harvey Himel,
a plastic surgeon on the team, are attracted by a long-term
association with the patients. "It's the real partnership with
the the patients that I treasure," Himel says. "I always feel
that I'm connecting with them." That connection can last for
years. Himel follows his patients from their most desperate
moments immediately after a burn, through skin grafts, follow-up
visits and sometimes through reconstructive and cosmetic surgery.
The New York burn specialists and their patients are benefiting
from some remarkable recent advances in operating-room
techniques and a more sophisticated understanding of how the
body reacts to severe burns. "Patients who 20 or 30 years ago
would have died now survive the injury," says Lisa
Staiano-Coico, dean of research at Cornell University Medical
College and the team's wound-healing specialist. "Now the issue
becomes one of how do we ameliorate the burn wound, how do we
improve the rate of healing with less scarring. Now it's gone
beyond survival."
As recently as the 1970s, a middle-aged patient with 40% of his
body burned had a 1-in-2 chance of survival if his respiratory
system had escaped damage. Today someone who has as much as 70%
of his body burned can expect the same odds. And the average
hospital stay for a severely burned patient is considerably less
than the old rule of thumb, which was one day for every 1% of
the body burned.
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