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contact us: asktheburnsurgeon@yahoo.com

Thursday, December 31, 2009

+Gravity, magnets and the energy problem+ (the "magral cell")

When God created man he put in a small brain and in that brain he made some neurons-not one, not two, but millions –we still do not know the exact amount. Why is this relevant?

It is our neurons that differentiate us from our fellow creatures. Our neurons analyze, sift and store information through complex interactions that we barely understand. Early man survived because of the discoveries he made; not from what he invented. Fire was always there before man discovered the flint stone. If he did not find water, his race would have disappeared. He made the wheel, but a log of wood rolling down the mountain slope- akin to a cylindrical wheel existed prior to this.

Over a period of time he instinctively realized that his existence was dependent on his ability to discover and harness existent energy in one form or the other. He used animals for farming and transport. He used the heat energy from the sun to give him salt (Nacl) something that we can hardly do without. Early man killed his prey, dried the flesh and stored it for the harsh winters. Dried wood was burnt and the energy released was used for cooking and keeping him warm.

Through the centuries our neurons worked overtime, as one generation climbed up on the shoulder of the previous one. The greatest discovery of all ages is considered to be electricity, which was pre-existent- a bolt of lightning release millions of volts of electricity. Our minds turned to electricity and we utilized it in all walk of life. Yet this electricity was not a panacea to all our problems. Producing it, distributing it and continuously generating it has always remained a problem.

We then turned to the nucleus that was also pre-existent. Our scientist and physicist worked hard to liberate ‘nuclear energy’. We used this energy to create ‘destructive bombs’ an endeavor in which we were successful. Did this solve our energy problem? Not at all! Our reactors are dangerous and potential bombs. We now restrict countries in the fear that nuclear wars will destroy our race!

In the midst of all this we discovered petroleum- natural gas in plenty. God had stored this for millions of years- one day man would need it. We then started using this to solve our energy problems. But as our population grew, our problems increased, our requirement for energy increased exponentially. We realized that this energy was limited and countries estimated that their resources would last a hundred or more years.
All these sources of energy were doing something that we did not expect-

it was destroying the very source of our existence. We were polluting the atmosphere, our water and destroying the ozone barrier. Global warming is now a serious issue!! Alternative source of energy become the need of the hour. Man turned to the sun again- now solar towers and solar fields are being developed. It does need a lot of resources, but how successful we will be? Only time will tell. ‘Wind energy’ is another source but is still limited. ‘Cold fusion’ appears to be a solution but we are still struggling with it. All this has given rise to the concept of ‘fuel less’ energy. New technologies are emerging day by day, use of water as fuel is still experimental and the feasibility will remain to be seen. Thus we realize that our search for energy will go on.

If we stop and ponder awhile and think how we reached here:

a man of science will argue that the ‘big bang’ was the origin- well what existed before the ‘big bang’- can we answer this question? For the religious, God created man. He created the sun and the stars, the moon and the earth. The sun liberates energy. The earth and the others rotate around the sun and the moon around the earth. This has gone for millions of years- we have no count. I am not a technologist- but the one force that existed from the beginning of our life is the gravitational force energy. It is that force that is so ingrained in our lives that we hardly look at it.

‘The greatest of truths are the simplest’.

It is clean, green and perpetually present. When Newton discovered gravity it was pre-existent from time immemorial. We understood gravity and we defied it in our planes and rockets and space flights. But did we use it- frankly we have not looked at gravitational energy as a permanent source of energy. Magnets maintain their attractive and repellant forces for years- we use them and our children play with them.

The question is can we combine these two forces- the gravitational force and the magnetic force’ to create a clean, green energy source! It is that source of energy that has kept our solar system in place and our planets in their orbit. Even our romances endure seeing the moon in place.

For a start, on a theoretical level, if we can evolve a system in which we have a series of attractive and repellent magnetic force, placed strategically on a wheel and couple it with the gravitational force- it may be possible to keep the wheel in perpetual motion. we could call this the '' magral cell'' (seen on the right) as it is based on the magnetic and gravitational forces. In part A gravity turns the wheel downwards while in the rest of the motion magnetic forces propel it upwards which should keep the wheel in motion. This motion can then be converted into energy. I am sure that intelligent systems or cells and models can be evolved by our present scientists. We need to harness gravitational energy and magnetic energy. This may be one of the solutions to the energy problem or at least it may cut down our energy requirements!

You might wonder what’s all this to do with burns and burns management? Well everything in life is connected. As a child I read in one of Flash Gordon’s comics- ‘You break a twig- you stir a distant star’. For quite some time I went around breaking twigs and even planned to cut down a tree – in the hope of seeing a star move. Energy development will affect all walks of life- medical and otherwise. Our very existence itself depends on our ability to generate energy. Our hospitals, theaters, and all devices use energy. If free energy is available –our lives will become simpler, the gap between the rich and poor will diminish and the lives of millions below the poverty line will be enriched. We can look forward to day when the basic necessities of life- food, clothing, shelter and basic health care will be available for all.

(an original thought provoking article from asktheburnsurgeon+) 

Wednesday, December 23, 2009

Friction Burns

++Dear Burn Surgeon,
My friend had a motorcycle accident. Though there was no fire the doctor says he has a “friction burn”. Can you please explain this?

Rajiv sood , Mumbai
Dear Rajiv, thank you for your question. When you rub the palms of your hands together, heat is created by friction. Similarly in the motorcycle accident when your friend fell off the bike, probably he was dragged on the road due to the momentum. The friction between the body and the road created a high temperature which caused the burn. However ‘friction burn’ is rarely a pure burn and there is often an element of traumatic injury (usually abrasions) involved in it, along with dirt and gravel that gets embedded in the burn wound. ‘Friction burns’ may either be deep or superficial depending on the drag and trauma involved. Friction burns that are superficial need only conservative management (ointment and dressings) after cleaning the wound to remove the dirt and debris. This is very important since tatooing of the wound may result from the dirt and debris which gets embedded in the wound. However deep burns may need surgery (skin grafting) as the skin will fail to heal by itself.
The picture on your right shows a ‘friction burn’ in a gentleman who suffered a motor cycle accident. There is a ‘third degree burn’ (see blog degree of burn) in the centre with 2nd degree burn in the periphery along with abrasions and the wound has debris embedded in it.

He was subjected to debridement (surgical cleaning of wound) following which a meshed skin graft (graft with holes in it) was applied over it.

The wounds healed well and the gentle man was advised to shift to a four wheeler and avoid two wheelers which are potentially dangerous. (I have still to see the owner of a two wheeler vehicle who hasn't had an accident). Friction burns can occur in sportsmen and wrestlers playing on mats, or on the carpet or the playground when they fall and their skin rubs against the rough surface.
Footballers who make a sliding tackle on a dry pitch may suffer from friction burns.
Other causes of friction burns include exercise treadmill at home which can cause accidental contact and friction burn from the fast moving belt. Rolling belts and fast moving belts used in industries can also cause friction burns.
Use of adequate protective clothing, headgear, knee and elbow pads, footwear and following proper safety precautions and protocols will be very helpful in preventing these burns in different situations. Friction burns should not be confused with redness and excoriation that may occur at different sites of the body due to infection or trauma. Tetanus prophylaxis should be given as per protocol if needed. Antibiotic are prescribed to avoid infection in patients who have dirt and gravel embedded in the wound.

The picture on your right shows a ‘friction burn” which was managed conservatively. Notice the scar with healing marks of the abrasions, obviously this was deep burn to begin with. This scar will need aggressive ‘scar management’ which is a topic by itself and I shall explain it in detail in a future blog.


Thursday, December 17, 2009

‘Sixth sense technology’ and +Burn management+


 Pranav Mistry with his ingenious “sixth sense” has amazed the world of technologists. What was developed over decades and appeared to be the “state of art” yesterday has been deemed “outdated” today. When Douglas Engelbart invented the mouse, little did he know that one day his mouse would lead Pranav into a new world of technology where the digital world would begin to comprehend human gestures.

For us as burn surgeons we still use the old fashioned Humby knife designed by Graham Humby while he was a medical student in Guys London hospital. Though we have mechanized it and made the dermatome, there is need for major technological advances. We need dermatomes that will automatically adjust the blades once the desired thickness is entered so that the skin is uniformly cut irrespective of the pressure applied. We need devices that will evaluate the burn depth intraoperatively and help to limit the extent of excision when coupled with the dermatome. We need devices that will continuously monitor the blood while the patient is undergoing surgery, evaluate the biochemical parameters (electrolytes, Ca, Ph, Hb levels and others) and correct them automatically.
We are lacking in skin substitutes which are presently not only expensive but also cumbersome. Besides skin culture is available in few specialized centers. Unless reliable and permanent skin substitutes are developed and skin culture techniques become easy to set up surgical management of major burn patients will always be a difficult issue. Tissue engineering and stem cells have a big role to play in burns and we are still in the ‘infancy’ in this area.
One important reason why digital technology has advanced rapidly is the large financial resources at hand. Financiers back with millions of dollars ‘tech geniuses’ whose ‘ideas’ they think will hopefully work out in the future and rake in millions. Obviously we cannot expect financiers to come forward in the burn arena where pain, suffering, human emotions and values play in the balance between life and death. This can be replaced by governments who must actively participate and provide strong financial backing for the meager few who enter as burn professionals. Philanthropic foundations must also actively participate in this endeavor. Health reforms must include burns as a major topic. More medical professionals need to be attracted to this field. Researches need to be encouraged, more grants need to be provided and international collaboration should advance our knowledge and understanding of burns.
The ‘sixth sense technology’ in burns need to be developed to alleviate the pain and suffering and create hope for patients with major burns.

Monday, December 14, 2009

Burn prevention -1

Dear Burn Surgeon,Can you please tell me about the first aid for burns and how to avoid burns in general?
Susan A.

Thank you Ms Susan for your question. There are two issues related to your question.

1. Prevention of burns in general.
2. First aid treatment of burns.

I shall address prevention of burns in general in this blog.

One of the most important aspects of prevention is ‘burn awareness ‘. Anything which is hot, which carries electricity, or is chemical in nature can cause burn. Your antennas must sense the danger as you carry on with your daily routines. When you enter the kitchen, cooking gas is the imminent danger. Keep children out of the kitchen. (See answer to question 1 in my previous blog for more information- Burns in kitchen). Avoid wearing loose and flammable clothing while cooking. Most longeries are highly inflammable and you stand the risk of the ‘fire’ falling in love with you and engulfing you. If you suspect a cooking gas leak, tighten all gas valves and open the windows. Avoid smoking, striking a match or putting an electric switch on as any spark will set the gas aflame and blow you out of the roof.Gas cylinders are potential time bombs in the kitchen and gas leak detectors can be of great help to detect leaks and control them.
Keeping a fire extinguisher in the kitchen is a good idea in case of a fire so is the smoke alarm or fire alarm. While using the microwave do not put in metal or food items that can explode like eggs or brinjals (also avoid plastics as they release toxic dioxins). Use pan handlers, safety gloves and hooks to handle hot utensils and avoid burns. While cooking it will be prudent to keep the pan handles away from edge if the cooking range as well as the other gas burners. Avoid storing anything or putting up shelves above the cooking range , so as to avoid burns while trying to reach them. Curtains in the kitchen or hanging towels can be dangerous particularly if they are close to the cooking range.

When you spread out lunch or dinner do not leave any hot stuff like soups etc unattended, your child will overturn it and get burnt while you are away. Always check the temperature of food made ready to feed your kids especially infants and toddlers (a thermometer will help).

While ironing realizes that your child can touch the hot iron and have a contact burn. Keep the hot iron out of reach of children. When you see your child playing with a lighter or match sticks- beware tomorrow he may light up the barn or set the house on fire or get burnt himself. Fire Crackers or fireworks are dangerous and if you have to burst a few crackers select the once which are really safe and always keep children under supervision.Rockets are dangerous and a misdirected one can cause havoc.

When your car radiator is over heated beware you might suffer severe scalds from hot radiator water; wait till it cools before you tinker with it. You shouldn’t expect a cold shower when you open a hot radiator lid. Candle lights are great and romantic but often are a source of fire in the house, especially if your child is inquisitive and decides to play with it. The bath is a place of relaxation after a hard day work but can cause burns if you are not careful especially in winter. Shower safe devices and tap devices which will let you monitor the temperature are helpful. Infants are unable to voice themselves and it is our responsibility to see that they don’t get burns when we wash or bathe them. If you are a diabetic or epileptic be careful in the bath as you may lose consciousness and suffer burns.

The bed room is relatively safe but if you decide to smoke or have hot coffee in bed, beware you will either light up your life or tip your coffee and burn your “main part”. Barbeques are exciting but keep children away and be careful while pouring petrol and lighting liquids over the coal. The guest won’t like to see you barbequed!! If you have chemicals in the house like drain cleaners, oven cleaners, acids or alkalis, beware you or your family can suffer chemical burns. Keep them safely out of reach of children and use them carefully. Avoid contact with eyes and hands and avoid inhaling them. The beach is a great place and basking in the sun can be good for your tan but beware sun tan can end in sunburns; limit your exposure and use a sunscreen with a good SPF.
Children in school beware- laboratories are places where chemical burns and fires occur, so be careful with your experiments. Safety first!

All electrical devices in the house – TV, video, radio, satellite receiver, computer, microwave, electric cooker and others are potential source of electrical burns. Earthing should be provided wherever needed, bare wires should be secured and plug points should be safe. Children should be kept away from all these devices. Warming milk bottles in the microwave ovens can be a source of infant burns and you must make sure of the temperature before feeding your child.
Gas leak detectors, smoke detector and fire alarms are of great help and should be installed in all homes. Every house, school, colleges, office or any establishment must have an ‘escape plan’ ready so that the inmates know how to escape in case of fire. Regular drills must be organized so that ‘fire escape’ becomes a natural instinct that overcomes the ‘fear factor ’.
I have found some great resources on the net which I have included as links for burn prevention on your right.

Along with ‘burn awareness’ a bit of “paranoia and a dash of obsession” will go a long way in preventing burns. This Christmas let us serve some 'burn awareness' along with our Christmas cakes.

wishing you all merry christmas +!!!!

Thursday, December 10, 2009

Cooking gas fires and burn awareness

Decades ago we entered the ‘space age’, but on the burn front we are still in the ‘stone Age’ especially in the developing and underdeveloped countries. Our forefathers discovered flint, we discovered petroleum, and natural gas- packed it and marketed it, but did we make it safe to use?

Not really!!+
Every year thousands of children, wives, husbands, fathers and mothers get burnt from cooking gas fires. The most common cause of fire is from a gas leak which catches fire from any source. Thousands are disfigured, mentally destroyed and physically handicapped from burn and undergo severe pain and suffering during years of rehabilitation.

We spend millions trying to make cars run faster, while our roads get smaller and congested as the number of cars on the road increase every year.
Is this logical??
The advent of globalization has its benefits. But price wars on products have led companies to make cheaper products, ultimately compromising on quality. We now use substandard products be it clothing that catches fire or electric wires that burn when the load increase. This trend must stop; quality must be standardized and not compromised if burn injuries and others are to be prevented. Companies involved in this field have a moral responsibility to make their product safe or at least support researches to find ways to make their products safe.

New technologies that will help to reduce burn accidents will need to be developed. We should install Gas leak detectors, smoke detectors and fire detectors in every house or place that use gas for cooking to help reduce the incidence of burns from cooking gas fire.
‘National burn day’ must become an ‘international burn day’. Schools, colleges, universities, shops, companies and all non-essential activities must stop on this day. Each and every individual must realize how burns occur and how it can be prevented.
Political games must rest for this day and for once politicians must join hands and minds and work on burn prevention and burn management strategies. On this day, the senate, the congress, the governors, all politicians and President Obama himself should talk and work only on burns. Burn awareness must culminate in a ‘burn awakening’.
If this is a dream, O God- please let it come true!

Friday, November 27, 2009

Burn area estimation or percentage of burns.

4) Dear burn surgeon, my son-in-law who is 34 years old was admitted to hospital with 22 % burns. Doc, is this a major burn and is it life threatening?
charulata s
sri lanka+
Dear Charulata,
You have raised three important issues:
1) What does percentage burn mean?
2) Why do we need to calculate the percentage of burn?
3) How do we calculate the percentage of burn.

1. What does percentage burn mean?
If we imagine and spread out the entire skin of our body it will cover 0.2-0.3 m2 while for an adult it will cover 1.5-2.0 m2 or 1.75 square meters approximately.
If we say that the face or the chest was burnt we will not have a clear idea about how much area is burnt, hence the area of skin burnt is mentioned in percentage as a standard for comparison. The entire skin area of the body is that is burnt is referred to as TBSA or total burn surface area.

2. Why do we calculate the percentage of burns?
Calculating the percentage of burns tells us if it is a minor burn, moderate burn or a major burn.

Minor burn- less than 10% burn area in children
-less than 15% burn area in adults
-burns that do not involve the head , feet, hands or perineum (genital and anal area) are included in this group

Moderate burn- burn area of 10-25 % in children
-burn area of 15-25% in adults
-2nd degree superficial burn of head, hands, feet or perineum are also included in this group

Major burn- burn involving more than 25%TBSA
others that are included in this group:
-full thickness burns more than 10% TBSA
-deep burns of the hands, feet, head, or perineum
-patients who have inhaled a lot of toxic smoke and suffer damage to lungs (smoke inhalation injury)
-high voltage electrical burns
-chemical burns

As the percentage of burns increases, so do the problems faced with management and healing of the burn wound. With increasing are of burn, more fluid is lost from the body and replacement in the form of intravenous fluids becomes a necessity. Thus children with more than 10% burn area and adults with more than 15% burn area will need to be admitted to the hospital for intravenous fluid administration. Furthermore as the percentage of burn increases, the rate of complications, sepsis or infection and period of recovery all increase. The availability of skin for skin grafting also decreases. Thus knowing the area of burn is extremely important before we start to treat the burn itself.

3. How do we calculate the percentage of burns?
The simplest way is ‘the rule of nine’ by wallace i.e. each part of the body is 9% or multiple of nine.

Head - 9%
Each upper limb - 9%
Anterior trunk – 18%
Posterior trunk – 18%
Each lower limb – 18% x 2
Genital area – 1%
Total =100%

This works well in adults but newborn, infants and preschool children have larger head, smaller body and lower limbs. The Lund and Browder chart accurately helps to calculate the burn are in these patients.

Lund and Browder Chart

If the area of burn is small and does not include whole parts of the body one can simply use the palm of the patient as representing 1% and calculate the burn area. For e.g. five palms that cover the area of the burn will mean 5% burn.
It is important to use the palm size of the patient and not your palm size!!!!!

Therefore charulata, a 22% burn is a moderate burn and generally should not be life threatening unless there is an associated serious inhalation injury to the lungs or there is uncontrolled infection.

Dear Burn Surgeon,
Can you please tell me about the first aid for burns and how to avoid burns in general?
Susan A.
Watch out for my next blog for the answer!!

Saturday, November 21, 2009

Degree of burns, Avoid burns in kitchen, temperature at which burn occurs, ice on burns?

1. Dear burn surgeon, I am always worried my naughty son will suffer burns since he is always around me in the kitchen. Also please tell me at what temperature does a burn really occur?
Vanessa A, ST Louis, MO
Dear Vanessa,

You have raised an important issue. In fact 90% of burns in children occur at home and the kitchen is the most common area where burns occur. The simplest and best way to prevent burns in the kitchen is to bar children from entering the kitchen. In my kitchen I had an extra door fitted, which came up to my son’s neck level so that my wife could see only my son’s face and he could not enter the kitchen. I had to increase the height of the door thrice!!! till he was mature enough to take care of himself. In case of infants or babies it is better to keep them in a movable baby bed with bars, along with some toys so that he can’t move out and keep the baby bed close to your kitchen so he does not miss you and you can always keep an eye on him. You could also increase the height of the cooking area and the shelves so that the child cannot reach any of these sites. Matchsticks and lighters should be kept in a safe area. Do not use table cloth in the kitchen as children will tend to pull on it and spill hot food, soups etc over themselves. In general, do not leave any hotstuff likely to cause burn unattended, when you have a child in the house. It is our responsibility to avoid burns in children.All electrical devices in the kitchen should be out of reach of children so as to avoid an electrical burn or shock. Electrical plug points should be child safe and wirings should not be exposed.

To discuss your second question,
The normal body temperature is 37 c or 98.4 f. Hence the body can withstand a few degrees more or less. However at temperatures of 40-44 c or 104 to 111.2 f the tissues suffer damage. The cellular proteins denature and even the cellular enzymes and pump mechanisms stop functioning. Over 44 c or 111.2 f it is difficult for the cells to repair this damage. So vanessa be careful when temperatures cross 40 c.

2. Dear burn surgeon, I read that immediate cooling of a burn helps, can I put ice on the burnt areas ?
Kimberly james, NY

Thank you Ms Kimberly for your question. Burns occur at high temperatures that begin to damage the skin and body tissues (See Q1). Logically if this temperature is immediately lowered, less damage should occur. Cold running water is the best way to do this. Hold the burn area under the cold running water till pain subsides for a few minutes (water conducts the heat away from the skin). For big severe burn areas one should be careful and avoid immersing in cold water as this can result in hypothermia (lowering of body temperature) and shock. Application of ice should be avoided for reasons of hypothermia as well as to prevent causing a cold burn (frostbite).

3. My friend’s daughter has a burn on the leg. The doctor says that it is a second degree deep burn and may need a special procedure called skin grafting.
Please explain this.
Lucio Paul M
S Africa

In what manner a burn wound will heal depends on how much damage the burn has caused the skin and body tissues. This is known as the depth of the burn and to understand this concept, one must know the layers of the skin.

In simple terms the skin has two layers
1) Epidermis – superficial or upper
2) Dermis- deep or lower

The fat, muscles, nerves, bone and organs lie below these 2 layers of the skin.

If only the epidermis is damaged it is called a 1st degree burn. This is akin to sunburn. There is redness (erythema) of the skin, pain and blanching (skin becomes pale on pressure).

When the epidermis and the upper part (superficial layer) of the dermis are damaged, it is called a 2nd degree superficial burn. This burn is painful (sensory nerves endings are not damaged), has blisters (fluid collects between epidermis and dermis) and burnt areas will still blanch when pressure is applied. The hair follicles and dermal glands are usually unaffected.

When the epidermis and most of the dermis is damaged, it is called a 2nd degree deep burn. This burn has less pain (sensory endings are affected) blood flow is affected and so the skin appears pale or white, may have small or no blisters (as deeper layers of dermis is burnt, less fluid can exude or pass out) and the hairs can be easily pulled out (as both hair follicles and glands of dermis are damaged).

When the epidermis and the whole of the dermis are completely damaged, it is called a 3rd degree burn. The burn area appears waxy white or brown or black depending on whether the burn has charred the skin. There is no pain as all the skin sensory elements are destroyed. Since all blood supply in the skin is destroyed the skin appears depressed (lower than the surrounding normal skin) and sometimes clotted blood vessels are seen in this burn area. When you touch the skin there is a leathery feel and all the hair are lost and dermal glands are totally damaged.

When the burn damages skin completely and extends into the underlying structure subcutaneous fat, muscles, tendons, blood vessels and bone joints it is called a 4th degree burn.

Why did I give you all these details?
Well, once you know the depth of the burn you can fairly predict the healing pattern and suggest the course of management though sometimes a superficial burn can become deep over course of time from many reasons.

The skin heals by regeneration of epithelial cells which are present in the hair follicles, sweat glands and sebaceous glands that are present in the dermal part of skin. Whether a burn wound will heal will depend on the depth of the burn and what percentage of hair follicles, sweat glands and sebaceous glands are destroyed.

Since only the epidermis is damaged in a 1st degree burn, the skin is easily regenerated and healing occurs without scar formation. 1st degree burn heals by simple ointment applications in about seven days.

2nd degree superficial burns do not damage the hair follicles and dermal glands but they take more time and tend to heal in 2-3 weeks.

2nd degree deep burns and 3rd degree burns will damage the hair follicles and dermal glands and therefore will not heal spontaneously. Instead of regeneration of skin they will end up as red raw area (granulation tissue) without skin. Hence one needs to remove skin from another part of the body and apply this on the burn areas after clearing the burn wound of all the dead tissues (debridement). This procedure is called skin grafting.

4th degree burns need more tissue than a thin skin graft and therefore a flap (tissue that includes skin, fat, muscle or bone) are required. I shall explain the skin grafts and flaps in detail later.

Uncommonly 2nd degree deep burns may heal between 3-4 weeks but they often end up with severe scaring and contractures (joints movement is restricted because of shortage of skin)
I hope this explanation will satisfy you.

+Introduction + In the United States of America 45,000 burn victims are admitted to hospital each year for treatment. The incidence of burn is quite high in other countries as well. Burn patients suffer enormous physical and psychological trauma often due to the lack of information and appropriate timely treatment. The recent advances in burn care, the different modalities of treatment, the availability of large number of skin substitutes, myriads of burn ointments and other aspects of burns have confused many who keep running from physician to physician or visit innumerable sites on the web in the hope of finding an answer. Over the past 25 years I have heard the same questions being repeatedly posed to me on burns and this has initiated me into starting this blogsite: http://asktheburnsurgeon.blogspot.com/
where I will attempt to answer questions related to burns for free, as well as express my opinion and thoughts. Experts in burn care are also welcome to express their comments on any questions posted here and these comments will also be published on this blogsite which will aim to create burn awareness among the community as well as help the burn patients. The blog should be useful for burn patients, their relatives, caretakers, caregivers, nurses, paramedical staff medical students, doctors and all burn care professionals. You can email your comments, doubts or any questions related to burns to: asktheburnsurgeon@yahoo.com . Please be patient as there may be some delay in answering your questions.
Why free? Well a burn patient is not a cosmetic surgery patient who is completely healthy and is looking for ‘something extra’. I feel society has a responsibility to help these patients who suffer enormous pain and mental stress. Imagine causing them more pain with financial stress just to get the right information!

'If this site will end up being helpful to burn patients, their caretakers and burns care professionals, the purpose of this blog will be served'.

Site disclaimer

All information contained on this blogsite: http://asktheburnsurgeon.blogspot.com/ is intended for informational, educational purposes and includes personal thoughts and opinions. The information is not intended nor suited to be a replacement or substitute for professional medical treatment or for professional medical advice relative to a specific medical question or condition. Please seek the advice of your physician or medical professional with respect to your medical condition or questions. As a recipient of information from this blogsite, you are not establishing a doctor/patient relationship with any physician. There is no replacement for personal medical treatment and advice from your personal physician. No material from this site should be used without the permission of asktheburnsurgeon.

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