NZ volcano tragedy: horrific burns may lead to amputations

Burns suffered by the White Island volcano victims are deeper than bushfire victims and may lead to limb amputations.

Burns suffered by the White Island volcano victims are deeper and more complex than bushfire victims, and many will require ­artificial and spray-on skin, with possible amputation of limbs in a few cases.

However, Jeremy Rawlins, president of the Australian and New Zealand Burn Association (ANZBA), says the world-class training of plastic surgery teams in both countries ensures the volcano victims will get the highest level of treatment.

“Every plastic surgery trainee in Australia and New Zealand has to take an ANZBA course, and it’s recognised as one of the best,” he said. “We do that course for times like this, and it gives our patients the best chance of surviving injuries like this.”

Dr Rawlins welcomed the transit of several Australian ­patients from New Zealand to burns units in Australia; one to Melbourne’s Alfred Hospital and 10 patients to Sydney’s Concord and Royal North Shore hospitals.

He said the experience of the 2002 Bali bombings showed it was both medically and psychologically effective to transport victims back home and close to their loved ones.

The Royal Perth Hospital burns unit, which Dr Rawlins now heads, received 11 intensive care patients within a 48-hour ­period after they suffered serious burns in the Sari Club bombings.

He warned that many of the White Island tourists were suffering far more complex burns than a house fire or bushfire victim.

Of the initial 31 patients, 27 suffered burns to more than 30 per cent of their bodies.

The tourists wore hard hats and gas masks but only light summer clothes as they walked a sightseeing loop to the edge of the inner crater.

“One of the complicating factors is the lava is very hot … A lot of these patients appear to have both thermal and chemical burns, caused by the reaction of lava and dust when it hits the skin.

“These are much deeper injuries and the patient becomes quite unwell because they are effectively poisoned by the chemical nat­ure of their injuries.

“Their burn wounds will require very deep excisions and significant reconstruction with artificial skins, or temporary wound tissue. It can be absorbed by the patient and effectively create the bottom layer of skin.

“We then harvest skin grafts from patients or use spray-on skin. I’d put money on the fact most will require artificial skins. And if they have very deep burns to their limbs, they may be heading towards limb amputations.”