Burns

This week, I switched over to the burns and plastic surgery service. They are very different entities. The burns service is a small one; as you might expect, severe burns requiring hospital stays are uncommon. The burns unit takes care of people with burns covering much of their body surface (from just 20% to 70%), deep third degree burns, burns involving the face, hands, genitals, and chemical or electrical burns. These patients are seriously ill. The patient I'm following was in a grassy hill when he fell asleep with a lit cigarette; another patient developed toxic epidermal necrolysis, a rare drug reaction with a 30-40% mortality; yet another patient is a psychotic patient who dumped herself in gasoline and lit herself on fire. It's actually really hard emotionally working in the burns unit; many patients don't even look human anymore. They cannot communicate, some have limbs amputated, and they are kept alive by invasive machines and monitoring. The surgical operation we do for these patients is skin grafting; we either harvest split-thickness skin grafts from the patients themselves or attach onto denuded tissue skin from someone else; sometimes, with large surface areas (imagine having to cover a whole back with skin), these patients look like a patchwork quilt. It's not hard surgery and students get to do a lot of suturing and stapling. But definitely not something I'd be interested in doing in the future.