In Burn News

“Why do I have to drive into the middle of D.C. to a burn center? There’s a hospital right by me.”

We hear this question all the time. I answer that burns are wounds, but wounds aren’t burns. Burn injuries are unique and require specialized treatment.

Even burns that appear mild or small can turn into serious injuries without proper treatment. Too often I treat patients whose wounds become infected after non-specialized treatment at a local clinic or wound center – even those that say they treat burns. It’s unfortunate when we have to perform surgery or a skin graft on a patient who may have been healed by now if they had come to a burn center for their initial treatment.

About 486,000 burn injuries require medical treatment in the United States every year – and they can happen to anyone, anywhere, at any age. We treat about 1,000 patients a year, with 600 admitted to the hospital.

When should I go to a burn center for treatment?

“I don’t want to bother the burn center specialists. It’s just a little burn. They’ll think I’m overreacting.”

I can’t say it enough: You’re not bothering us, and we don’t think you’re overreacting. We’d much rather see you now for a burn that doesn’t require a lot of care, than to later manage an infected wound or perform surgery that could have been avoided.

The American Burn Association has a list of criteria for which they recommend you receive treatment from a burn center, including:

  • Burns that involve the face, hands, feet, genitalia or major joints
  • Third-degree burns, which can appear whitish, charred or translucent with no pinprick sensation in the burned area
  • Burns that cover more than 10 percent of total body surface area
  • Electrical or chemical burns
  • If you have pre-existing medical conditions that can complicate recovery

What makes a burn center unique?

“I liked the plastic surgeon who performed my surgery last year. Can’t he do a skin graft?”

Surgeons outside of burn centers can perform amazing skin grafts and debridement (removing damaged tissue from a wound). But what makes a burn center unique is the team approach we take to treating burn patients.

Burn center specialists are dedicated to treating only burn patients. They can include:

  • Burn rehabilitation specialists
  • Burn surgeons who have additional training in burn, trauma or critical car
  • Dietitians
  • Nurses with special training in caring for burn patients
  • Pharmacists
  • Social workers

When you’re not treated at a burn center, coordinating care becomes more difficult. You may have surgery at one place and rehabilitation across town. Getting plugged in with a burn center from the beginning makes coordinating downstream care that much easier and can benefit your physical and psychosocial health.

The biggest progress made in burn injury survival did not come from antibiotics or advances in critical care. It was the organization and verification of regional burn centers.

Centers such as The Burn Center at MedStar Washington Hospital Center must meet rigorous criteria to be considered a burn center. There may not always be one right next door. After ours, the next closest burns centers are in Baltimore and Richmond, Va.

D.C. residents are fortunate to have a burn center nearby. For those who do not have a burn center in their community, travel to the nearest burn center for care if you can. I want you to receive appropriate care from the beginning so you can avoid potential complications down the road.

If you have a burn that meets these criteria or that you would like a burn specialist to look at, request an appointment or call 855-546-1974.

By: Jeffrey Wilson Shupp, MD, FACS
Burn Center Director, MedStar Washington Hospital Center; Washington, DC

Jeffrey Shupp