Grafting hope
By Stu Hutson

 It’s 7:30 p.m, just a little after bedtime for most of the children at the Boston Shriners Burn Hospital. Pictures of fuzzy animals and popular cartoon characters don the walls. A few nurses calmly stroll along wearing candy-store colors. Down the hall, there’s a playroom with all the toys a kid could ever ask for.

At first glance, you’d expect the worst case here to be a tonsillectomy patient who’s been eating too much ice cream.
Bob Sheridan, chief of burn surgery, gives his watch a quick glance and starts his rounds. First on the docket: Lisa, room 803. Only five-years-old, she was badly burned over much of her right side two days ago when an electrical fire broke out in her room while she was sleeping. She’s relying on a respirator, but her attending nurse has to stop in every hour or so to change the position of the hose connected to her mask so that she can lie with her face in a different direction. If her head is still for too long, the burns on her neck will begin to form tough scar tissue that will tether her head in that position.

As bad as she looks on the outside, twenty years ago it would have been her internal organs--her lungs and heart--that would have concerned Sheridan. Most severe burn victims, especially children, die from the broiling their lungs take from the fire’s super-heated gases, the muck left over from the smoke, or the extra strain on a heart that’s beating like a blown tire to rush blood to damaged tissues and to lungs gasping for oxygen. The greatest advancements in treatment have come from simply learning that, before work begins on closing wounds, the patient needs the proper fluids and oxygen-rich air from a respirator.
“Now, our biggest concern usually isn’t survival,” Sheridan says, “It’s making sure that the patient can come out of the experience and get back to as much of a normal life as possible. And that means dealing with scarring.”

Thankfully, the fire spared Lisa’s face; but her neck, right arm and leg were badly hurt. The human skin can take a remarkable amount of damage. Still, burns aren’t normal injuries. You can’t sew them up like a cut. You can’t expect them to mend like a bone. “The body doesn’t know how to react to a burn,” Sheridan says. Evolution has equipped our bodies with tools to deal with bumps, slashes, and even extremes in weather. Burns trick these tools into working against us. When the body tries to scar over large, severely damaged areas, the skin becomes inflexible, numb, and...