Successful treatment of critical burns on the example of firefighters: case study presentation

Abstract

Relevance. The profession of a firefighter involves performing tasks in extreme conditions and is associated with an increased risk of occupational injuries. Despite organizational and technological measures aimed to prevent occupational injuries or death, there are frequent cases of traumatic events in the line of duty, including extensive burns. Such cases are often of a group nature and attract significant public attention.Intention. To present a clinical case of successful treatment of two firefighters who got severe burn injuries in the line of duty.Methodology. The surgical tactics and features of the intensive care of two severely burned firefighters with an unfavorable prognosis, according to the common prognostic scales, are described. The first national experience of large-scale (more than 15 % TBSA) application of novel skin equivalents – dermal regeneration templates is discussed.Results and Discussion. Outcomes of injuries in both cases were favorable. It was possible to avoid severe disability of the patients. This result was achieved through the implementation of modern treatment strategy of critical burns, namely multidisciplinary approach from the moment of admission; early aggressive removal of non-viable tissues, which allows interrupting the pathogenetic mechanism of burn disease; active use of temporary substitutes for the skin, including those of biological origin – the so-called skin equivalents; early restoration of the skin with the priority of functionally active areas (hands, neck, large joints); primary reconstructive surgeries, involving the use of complex plastic methods in the acute period иof injury. Being more resource-demanding, early surgical treatment of burns provides not only reduction of hospital stay, but also a decrease in mortality and improvement in the functional outcomes.Conclusion.  The experience of treating these patients demonstrates on the high role of the organization of burn care and the use of new technologies. Novel biological skin substitutes help overcome the lack of donor resources, associated with extensive deep burns. Despite the unfavorable prognosis, the complex application of innovative medical technologies not only provided a favorable outcome for injured firefighters with severe burns, but also allowed them to return to service.