As the war continues in Iraq, the U.S. military is searching for ways to deal with combat injuries, including burns. St. Joseph Hospital Regional Burn Center and several staff physical therapists will be involved in a military study looking at the rehabilitation of burn patients.
“The U.S. Army is currently swamped with burn cases,” said Paul Young, staff physical therapist. “Army physical therapists are concerned that no matter how hard they work - and their survival rates are climbing - rehab success has stalled. Patients are alive but have tremendous rehabilitation burden issues on the rehab community.”
According to materials Young had received for the study, as of February, there have been 600 burned soldier cases, in Iraq operations; the average size of the burn being 16 percent of the body surface.
What the U.S. Army Institute of Surgical Research at Fort Sam Houston in San Antonio and their lead physical therapist, Reg Richards - who is heading the project - wants to know is what physical therapists should be doing from Day One in a patient's care to achieve a positive outcome.
They will look at data from 13 to 15 civilian hospitals. St. Joseph Hospital was asked to take part in the study because it is a verified regional burn center by the American College of Surgeons and American Burn Association. The United States has fewer than 130 verified burn centers.
“They are looking at civilian data to speed up the process,” said Young. “They will be asking hospitals to answer the question, how many hours of physical therapy care does it take for these patients?
The most debilitating result from a severe burn is contracture, a tightening of the skin over the burn that restricts a patient's movements, Young said. Contracture can disable a person, depending on where the burn is, such as a joint area. It is important from the beginning of treatment to keep these areas as soft and mobile as possible so they don't tighten up as they heal. Shoulders, neck and hands are most at risk for contracture, followed by elbows and knees.
According to the National Burn Repository 2005 Report, the mortality rate of burn patients dropped from 6.2 percent in 1995 to 4.7 percent in 2005. The average length of a hospital stay has declined from 13 days to eight.
“But our rehabilitation burden rates have stayed the same. We are still suffering from lack of mobility and functional outcome deficits. For the past 20-30 years no matter how hard we work or how fast the surgeons work we are still having problems,” said Young.
Patients in the study will have to give their informed consent, and all information will be confidential. The therapists will record daily what type of care they gave the patient and how much time was spent on the individual. In addition, any pre-existing condition is looked at, as well as physical factors like how many days patients were on the ventilator or how long it was before they started walking.
Once the patients are ready to be discharged they will be given a physical and that data will be added into the computer database.
The study will start sometime next year and run for three years.
“Richards wants to make sure that soldiers are getting top-notch care so they can stay in active duty,” said Young.
“This study is almost like a surveillance study. I suspect the therapists, myself included, will work a little harder,” said Young with a smile.
