{'fraction_non_alphanumeric': 0.03426017874875869, 'fraction_numerical': 0.02730883813306852, 'mean_word_length': 4.997023809523809, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 1, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Management of Burns in a Modern Conflict – The Mitchiner Memorial Lecture 2007

Corresponding Author: Professor Stephen M Milner MB, BS, BDS, FRCS [Ed], FACS, Department of Surgery, Johns Hopkins Bayview Campus, 4940 Eastern Avenue, Baltimore, MD 21224 Tel: 410 550 08836 Fax: 410 550 8161 Email: smilner3@jhmi.edu Introduction It is little known that General Mitchiner had an interest in burns. The subject, featured in his Hunterian Lecture to the Royal College of Surgeons of England in 1933, was followed by an entire textbook, “The Modern Treatment of Burns and Scalds,” two years later [1]. In Mitchiner’s lecture “Surgery in Two Wars” delivered before the Royal Faculty of Physicians and Surgeons of Glasgow, on January 29, 1947, he concluded, “Burns have been more common and more extensive in the recent war. It is difficult to obtain any figures of the mortality, since so many died before reaching medical aid or, after first-aid treatment, before getting back to base hospital” [2]. Today, mortality has been drastically reduced. Improvements in initial resuscitation, control of infection and reconstructive surgery, enable patients with burns in excess of 95% not only to survive but to expect a reasonable quality of life. Unfortunately, however, the figures coming out of Iraq show that the mortality rate for combat burn patients with a total burn size over 50% is only 52.5% [3]. The reasons for poor survival statistics can be understood by examining medical care under battle conditions. The handling of mass casualties is compounded in war by primitive facilities and the constant threat of enemy fire. This was illustrated by the dressing station at Ajax Bay during the Falklands campaign where there were no static medical facilities, inadequate numbers of staff and equipment, the problem of sheer numbers and the uncertainty and confusion of the “fog of war”. This paper discusses the advances in burn care, built on General Mitchiner’s contributions to the welfare of the injured soldier.