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Richard Kagan Reviews 45 Years of Pediatric Burn Care
June 21, 2017 | Lindsay Morgan
Burn injuries occur in 2 million people every year in the United States, according to the American Burn Association, resulting in at least 450,000 hospitalizations and more than 3,000 deaths. Children are especially vulnerable to burn injuries; almost one-third of all burn injuries occur in children under the age of 15; and children under five are 2.4 times more likely (pdf) as the general population to suffer burn injuries that require emergency medical treatment.
Great strides have been made in burn care, however. According to Rowan et al 2015 , "The survival rate for admitted burn patients has improved consistently over the past four decades and is currently a favorable 97% for patients admitted to burn centers. This can be largely attributed to national decreases in burn size, improvements in burn critical care, and advancements in burn wound care and treatment…."
Visiting UC San Diego's Department of Surgery to discuss these advances—and the challenges ahead—was Dr. Richard J. Kagan, MD, FACS, Chief of Staff Emeritus, Shriners Hospitals for Children-Cincinnati (SHC), who, on June 21, 2017, delivered the 14th Annual Hansbrough Lecture. View program (pdf). The annual Hansbrough Memorial Lecture was established in 2003, to honor the life and work of John F. Hansbrough (pdf), MD, the former Director of the UCSD Burn Center. It brings to campus the country's top minds in burn surgery and research, including Dr. Kagan, a nationally recognized expert in acute and reconstructive burn care, tissue banking, skin substitutes, burn center reimbursement, and acute and chronic wound care who has served as president of the American Burn Association and the American Association of Tissue Banks.
In his presentation, 45 Years of Pediatric Burn Care: The Cincinnati Experience , Dr. Kagan reviewed changes in burn care over the last 45 years, and advances at SHC specifically, including early referral; fluid resuscitation; nutrition support; burn wound management; improved survival; and an emphasis on physical and psychological rehabilitation.
UC San Diego's Regional Burn Center has, along with SHC, been one of the leaders in advances in burn therapy. Since 1973, the Hillcrest-based facilities and team of physicians, nurses, therapists, and social workers, has provided San Diego and Imperial Counties with state-of-the-art care for burn victims; support to families and friends; community education; emergency medical personnel training; and conducted research to advance burn care. The Center is currently preparing to launch a laser program to help patients with scarring and discoloration, due to launch in early fall.
Dr. Jeanne Lee, MD, FACS, Director of the Burn Center, agrees with Kagan that the field has made enormous progress: "The field of burn care and healing has made huge strides over the last several decades, and probably the most important advancement in the last 40 years is early excision and grafting, which has led to a dramatic decrease in mortality and morbidity especially in patients with large burns."
During his remarks, Dr. Kagan stressed the importance of training up the next generation of surgeons who will "lead and push themselves, and innovate."
Dr. Lee agrees: "the next big hurdle to overcome in burn care is finding more surgeons who want to care for burn patients. There are currently not enough people being trained in burn care to fill in the gaps that will happen with the next generation of burn surgeons retire." Dr. Lee added that: "a skin substitute or a better way of growing skin to use on patients with large burns and small donor sites so that we can get them covered and grafted faster" is another key priority for the years ahead.
Learn more about the UC San Diego Regional Burn Center
About John F. Hansbrough
John F. Hansbrough was recruited to UCSD in 1984, and, for 17 years, he helped to make the UCSD Burn Unit an internationally recognized center that delivers excellence in care and pioneering research, including describing the immunosuppressive effects of injury, and the challenge of developing wound coverage using artificial skin. Dr. Hansbrough's deep commitment to research continues to inspire us all at the Department of Surgery, as we pursue solutions that lead to tangible changes in care. View Dr. Lee's opening presentation on Dr. Hansbrough's accomplishments at UCSD.