Episode Transcript
Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.
Host: Hot oil, barbeque grills, falling into a campfire; you know I don't think that there's much more that is more terrifying than a severe burn. We are here with Dr. Stephen Morris Medical Director of The University of Utah Burn Center to talk about severe burn cases, why they're so bad, and the recently renovated Burn Center at The University of Utah Hospital. Thank you for taking some time to talk to us today.
Dr. Stephen Morris: Thanks for having me.
Host: For me anyway there's nothing much more terrifying than a thought of a severe burn. From a medical stand point is that the case as well? I mean that's kind of the worst of the worst. How bad is it?
Dr. Stephen Morris: Yeah the pain in and of itself is very terrifying. I think all of us we've had small burns and we know how much they hurt.
Host: Yeah.
Dr. Stephen Morris: And we can imagine if a patient has fallen into hot water, or had severe flame burns, over more than half of their body how much it hurts as well as how badly it affects them.
Host: Yeah, so what are some of the things that a burn will do to the human body that you're worried about if somebody comes in?
Dr. Stephen Morris: Well what we worry about initially is just maintaining the circulation because that's one of the first things to go.
Host: Really?
Dr. Stephen Morris: And the patience will lose fluids in there burns. They will also lose fluids throughout their body and so they become very swollen, and they become severely dehydrated and go into what we call Burn Shock, and so we have to worry about that. Likewise, they can often have severe problems with breathing. They can swell enough to block off their airways, or they can have injury that goes down to their level of lungs so their lungs don't work properly and so they can die from breathing problems as well.
Host: Even if they just burn their legs it can affect the lungs?
Dr. Stephen Morris: Correct.
Host: And your circulation throughout your whole body?
Dr. Stephen Morris: Correct.
Host: What are your other concerns that you have? Are infections a concern?
Dr. Stephen Morris: And that's just what I was going to say, and the next thing...The next thing down the road of course is trying to get the areas where the skin is now destroyed get that covered because you can imagine skin is an important barrier to infection.
Host: Yeah.
Dr. Stephen Morris: And so through their lungs, through their intestinal tract, and through their open wounds of their skin we have great concerns of infection, and that ends up being one of the causes of death in burn patients.
Host: Okay, so then a burn patient comes in you take care of a couple of the first issues, you try to take care of infection, what then? I mean the skin's damaged will it ever grow back?
Dr. Stephen Morris: It depends... If the skin is only partially burned through then of course the underlying areas will regenerate. We call that a partial thickness, or second degree burn.
Host: Okay.
Dr. Stephen Morris: But frankly if it's burned all the way through, no that skin will not grow back.
Host: Yeah.
Dr. Stephen Morris: And that's where surgery is required to remove the dead tissue and to put new skin in the areas where the skin was destroyed.
Host: And where do you get the new skin? Do you have like a skin bank here on site, or...?
Dr. Stephen Morris: Well the skin bank that we use actually had its origins in this hospital, now it has gotten much larger, and is off site, but the problem with bank skin is that it is temporary.
Host: Okay.
Dr. Stephen Morris: No matter where you get the skin, unless you have an identical twin that is, you have to use your own or it will reject. We can't use anti-rejection medicines like heart transplants, and lung transplants, and kidney transplants do because of the infection problems.
Host: Okay.
Dr. Stephen Morris: And so the skin has to come from the very patient who is injured.
Host: So you have to find some good skin and then start the process of doing some transplants?
Dr. Stephen Morris: Correct, these transplants are called skin grafts, and that's exactly what we do a lot of here.
Host: And how long of a process is that for somebody that's burnt maybe on 15%, 20% of their body?
Dr. Stephen Morris: Well there's a generally accepted rule of thumb, maybe it's a little antiquated, but the rule of thumb is this, for every percent of your body surface area that's burned, and if you look at your hand, the palm surface, the fingers, and the palm together that is 1%.
Host: Okay.
Dr. Morris: And so in a full grown adult that's a pretty good sized area, in a little child it would be much smaller.
Host: Yeah.
Dr. Stephen Morris: But we figure that every percent that is burned will require about one day in the hospital.
Host: Okay, wow.
Dr. Stephen Morris: So a 15% burn would be at least a couple of weeks.
Host: Yeah, so tell me a little bit about the renovated burn center. What makes this facility so incredible?
Dr. Stephen Morris: Well it's the people that work here I think that make it incredible, but they need to have a facility where they can actually do their job.
Host: Yeah.
Dr. Stephen Morris: And we've had a burn unit here with 12 beds for the past 30 years, and we've outgrown it. Certainly we're busier than we were back then, but more importantly I think we've learned how to take care of patients even better, and we needed to update the facility so that we could do the best possible job.
Host: What's different from this facility than the old facility and how does that help you treat patients better?
Dr. Stephen Morris: I think it's the space. We were so crowded it was actually fairly cramped. We have expanded to more than twice the area to take care of about the same number of patients and so it makes it much more comfortable for the patient; it makes it much more comfortable for the families, and the friends, of the patient.
Host: Is there anything else like this Burn Center in the Intermountain West?
Dr. Stephen Morris: No we are what's called a Verified Burn Center that we are independently assessed, and reviewed, and there's nothing like this Burn Center between Denver and the coast.
Host: All right.
Dr. Stephen Morris: And from the Canadian Border down to Phoenix, and so it really is the largest area for a single Burn Center to cover in the United States.
Host: Now what does this all mean for patients and/or people that live in the five state area of University of Utah Hospital Burn Center?
Dr. Stephen Morris: Well that means that they can go to bed at night knowing that we're, you know God forbid that they're injured, but were they severely injured, or were they to have a severe problem where they would lose their skin or have bad wounds that there's a facility that is quite close to home that provides world class care.
Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Science's Radio.