The Worst Thing I’ve Ever Seen
My patient was a teenage girl who was taking a nap at home. As she slept, a reckless driver crashed into her house, causing an electrical fire, igniting a ruptured gas line, and setting the entire house ablaze.
Originally she got out with her sister, but went back in to try and rescue her dad and dogs. When firefighters pulled her out, her body was 95% burns.
When she arrived in ICU we registered smoke inhalation, lung damage, carbon monoxide, and cyanide poisoning plus toxic inhalation.
She survives the initial presentation to the trauma unit and now she’s in our burn unit, and it’s only going to get worse before it gets better. The only intact skin on her body was a small area around her inner thigh.
Her hair, face, eyelids, and lips are gone. We do what we can with moist sterile dressings and debridement plus broad-spectrum antibiotics.
At the end of the day, she looked like a mummy fully wrapped by the end. There is no chance of her having a normal life ever again. The chances of her surviving are in the single digits. After a few days, the infection begins to set in.
All that damaged tissue was a breeding ground and the first thing we noticed was the smell. The only thing you can really do to encourage healing at that point is IV/Topical antibiotics and debridement.
Basically, large wounds heal better when they are scraped or shaved to expose the wound bed. This removes dead cells which hamper growth and encourages new skin formation.
It takes weeks of treatments, and we had to do this all over her body. This was scheduled multiple times per week. One day, I said out loud in the OR, “This is the worst thing I’ve ever seen in my life.”
Several years in medicine later that statement remains true. She survived the next few days, and we started with the skin grafts. Trying to re-build her face, and cover her body.
Her average surgery time was about 10 hours per procedure. We have to keep the room at 98 degrees because burn patients go hypothermic quickly.
This meant 10 hours in full scrub gear at nearly 100-degree heat. Allopathological