3rd degree chemical burns-nothing's working!

[JenniferTaylor728]

Hello,
I'd appreciate greatly any input.  My dear friend suffered mostly 3rd degree burns to 65% of his body from chlorine dyoxide the beginning of October.

He's had 13 surgeries. Experienced some kidney failure, has pneumonia, and most recently has suffered from low blood pressure--which is, as I understand, the reason why none of the skin grafts have "taken".

He is on Levophed, and they basically can only take him off of it during surgeries.  He has been intubated since day one and has been heavily sedated.

Family and friends are just sick with worry as 13 surgeries into this, there has been NO progress.

Does anyone out there have any advice/comments/concerns?

Thank you so much for reading this.

Jennifer

[Jeffrey S Guy, M.D., M. Sc.]

I am very sorry about your loss.   The burn center should have a social work that should have been working with the family all along with coping and grief issues.   I do not know of any online, but the first place I would check would be some of the other forms here at medhelp.   Your friend has been through a gread deal of stress and certainly at risk for problems of her own given all of the crisis she has had to endure.  

[JenniferTaylor728]

My friend died last night...10 weeks after the accident..he had gone thru two more surgeries since my last post. Some of the grafts had actually started to "take", but a week ago he developed an allegeric reaction to an antibiotic that he was taking and went into "v-tac" and was done for 14 minutes before they were able to resucsitate him.  After that, they took him off the ativan to judge brain activity and did another surgery.  He started having platelet replacement (he was bleeding into his lungs) and then his kidneys started shutting down again..in addition to sepsis..
I was wondering if you could recommend an on-line grief support group...his fiance is just devastated...she went into shock and was unconscious for 3 hours in the emergency room after he died.
I've helped her through her child's death, a nasty divorce, and now this. She's not a religious person...
If you could give me a few links or suggestions, I'd appreciate it.
Thank you.
Jennifer

[Jeffrey S Guy, M.D., M. Sc.]

I think you are likely correct.   When the patient has a good deal in regards to critical care issues, ie. renal failure, respiratory failure, pneumonia, and shock, the body has to place a priority on items such as blood flow and oxygen delivery. The body will send blood/oxygen to brain/heart/kidney prior to skin/burn.  Therefore, one will usually get off all the burns as the burned tissue produces chemicals that cause an inflammatory response that affects all the major organs.   Then place the excised wound in biological dressings until the critical care issues have resolved.  Then the body will be more likely to take the grafts.  

[JenniferTaylor728]

Thank you so much for taking the time to read my post. My friend is in his late 30's. The doctor's have done numerous grafting surgeries already--all of which have been unsuccessful.  I'm beginning to feel as if they should just let his body rest, rather than trying to graft. They have done several debridements...but follow it up with unsuccessful grafting.
Any comments/suggestions would be much appreciated.
Thank you again for reading and replying.

Jennifer

[Jeffrey S Guy, M.D., M. Sc.]

Chemical burns of this size are a real challenge.  There are so many things that can be complicating factors in a patient this size.  With the shock and the kidney failure,  skin grafting is not a good idea and not likely to take.  Therefore, the wounds should be excised, and I am sure they have been by this point.  Typically, with someone this ill the wounds are covered with a biological dressing such as cadaver or pig skin until the physiology improves and that can take weeks.  

How old is your friend?