Ahmedabad: Survival of 71% deep burns in our country is rare. In today’s pandemic, the added scare of covid-19 infection to such high percentage of burns proved to be a real challenge for the doctors at SVP hospital. A 23 year old young mother of an 8 month old child suffered an accident she never would have imagined. She suffered severe burns while cooking at home on 09/05/2020.

With multiple hospitals shut and many others designated as covid centres, the relatives began their search for a hospital that would admit her. After enquiring enough, she was admitted to LG hospital. A routine COVID testing at LG hospital showed she was positive for COVID. LG being a non-covid centre, she was referred to covid designated SVP hospital on 11/05/2020.

She was under combined care of Plastic Surgery department treated by Dr. Vijay Bhatia and team and Medicine unit treated by Dr. Ami Parikh and team. Citing that she had sustained 71% burns in addition to being covid positive, the chances of survival appeared to be quite slim. Relatives were very anxious and worried about the outcome. In addition, the fear of death crippled their minds. Doctors in medicine managed covid effectively and she became covid negative after 3 weeks of treatment. During this period she underwent each dressing under sterile conditions by the team of doctors in department of Plastic and Reconstructive Surgery.

After the wound bed was prepared, the need for homograft (donated skin from skin bank) was explained to the relatives as patient’s skin alone (autograft) would not be enough to cover the large area of burn wound. After thorough talk with various skin banks, the skin was only available at KLES Dr. Prabhakar Kore hospital and MRC, Belgaum. Now, the hurdle was non-availability of cold chain courrier system. Despite difficulties due to nation-wide lockdown, the relatives drove all the way for nearly 36 hours to Belgaum and personally procured the homograft.

As soon as the homograft reached us, she underwent her first surgery with combined application of autograft and homograft on the same morning within one hour. Subsequent dressings showed acceptance of graft with healing of nearly 70% of the prevalent raw areas. She required second surgery with autografts after a fortnight(2 weeks) of the first surgery to cover the remaining 30% of the raw areas.

It was a challenge to treat the patient without risking the health of medical and paramedical staff involved in her treatment. As per the data available, the survival rate of 71% burns matched to her age is only about 18-20%. As covid is a recent disease itself, its effects on various body systems are unclear and till date no definitive treatment is available. Lastly, burns is definitely an immunocompromised state and covid infection could prove to be disastrous in such patient. During her stay of about two and a half months, she underwent two surgeries, 35 dressing changes, 14 blood transfusions and 40 albumin transfusions.

The hospital said: ‘as per our knowledge, this is a first of its kind patient in the world who has fought two problems simultaneously i.e. covid and burns. We could not find any such case in literature online. It is with great pleasure that we have discharged her today, fully recovered, walking back to her life.’