Maile On Burns: “Cure Occasionally, Relieve Often, Console Always”

Dr. Robert Maile discusses the evolution of the treatment of burn injuries. (Photo by Matt Molek)
Dr. Robert Maile discusses the evolution of the treatment of burn injuries. (Photo by Matt Molek)

Dr. Robert Maile’s presentation at the Natural Sciences and Mathematics Colloquium Wednesday, titled, “The Challenges of Burn Injury,” focused on the impact of trauma and burn-related emergencies on the individual and society, and the state of current research in the field of burn immunology.

Maile, a researcher in the surgery department of the Jaycee Burn Center, University of North Carolina, began the seminar with the history behind burn immunology. He focused on the first written accounts of burn treatment, which dated as far in history as 1500 BCE, and the works of battlefield-trained surgeons like Ambroise Paré who used a basic understanding of burns to better treat wounded soldiers.

From its history, Maile went on to discuss the numbers behind trauma and burn injury, concerning not only the death toll but also the economics behind medical and hospital costs.

“[Burn injury] is a rare mechanism of injury,” said Maile. “But, it often involves the longest hospital stay.”

Statistically, more burn injuries occur in the mid-twenties, early-thirties age group, and more so among men than women. The injuries occur most often in the home, are not work-related, and are caused by a direct fire or scalding. The chances of receiving a significant burn are 1 in 50, while the chances of dying from that burn are 1 in 500.

Maile also elaborated on the physical aspects of a typical burn, not only how it affects the skin but, most importantly, how it affects the rest of the body and its dysfunctional immune response.

“[Burn injuries] are a profound multi-system problem,” Maile explained, and despite the extent of some injuries, “burn patients tend to die of pneumonia” due to the anti-inflammatory response of the body to counteract an initial pro-inflammatory response.

Skin grafts from the burn victim, called autografts, are more commonly used than allografts (skin grafts from another person) to cover the wound and prevent infection, usually to prevent the immune rejection of foreign tissue that persists long after the body is immunologically compromised. Maile added that synthetic grafts can also be used to establish a barrier between the wound and the environment.

“Autografts or synthetic grafts are your best options,” Maile said.

The Jaycee Burn Center is studying many mechanisms behind burn injury and the body’s immune response. While many burn centers are shutting down due to the high upkeep costs of treating burn victims, Jaycee is still combining patient care with immunological research to better aid burn patients.

Maile ended the presentation with a discussion of projects being researched at the Jaycee Burn Center, ranging from a study of inflammatory cytokines to an investigation behind the reactivation of latent viruses that could accompany the body’s immune response to burn injury.

“Sometimes, it sounded like he was trying to sell his program, but it was interesting to hear about the research he was doing,” said Jesse Burke, a sophomore who attended the lecture.

Dr. Maile concluded his presentation with a restatement of the medical humanities, fitting for a presentation on a medical unit focused on burn injury: “cure occasionally, relieve often, and console always.”

The NS&M colloquium series is held weekly, and offered to a general audience. The next seminar is titled “Field Notes on a Catastrophe,” a global warming presentation based on the book written by The New Yorker magazine journalist Elizabeth Kolbert. Kolbert will be presenting the seminar next Wednesday.

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