‘Burns: The Evolving Wound’ – Leeds Advanced Wound Care Workshop Presentation

On 1 September 2016, the AHRC-funded ‘Forged by Fire’ project team officially commenced its work. Within three weeks, team members fed into their first academic meeting. Jonathan Reinarz and Shane Ewen took part in the first of three, AHRC cross-disciplinary workshops at the University of Leeds. Under project leads, Mary Madden and James Stark, the workshops will explore innovation in ‘advanced’ wound care its wider historical and sociological context (for more see http://wounds.leeds.ac.uk/). The September event focused on health professionals, patients and industry. It explored key questions, including those round the developed of wound care and it situation within the longer history of wound care and the development of the NHS. Held at the Thackray Medical Museum, the meeting was particularly memorable due to the presence of an artist, Tom Bailey, who created works inspired by the seven papers presented on the day. With the permission of Tom, three of his images have been used below to illustrate this first post on the ‘Forged by Fire’ blog.

As part of the workshop programme, Jonathan delivered a paper entitled ‘Burns: the evolving wound’. Besides introducing our project to the people in attendance, Jonathan’s paper explored the way in which burns have been conceptualised by health professionals over approximately the last two hundred years. Originally conceived as surface injuries that were best treated topically, burns were gradually recognised as having an impact that was more than just skin deep. Already by the mid-nineteenth century, hospital physicians were writing about the way in which burns appeared to cause ulcers to the intestines, and the fact that burns survivors seemed to suffer disproportionately from pneumonia and other respiratory diseases. By the twentieth century, practitioners began to focus on ways to remedy the great shift in bodily fluids regularly experienced by those with extensive burns. Over the next decades many more specialists joined burns teams, not least bacteriologists, surgeons, psychiatrists and social workers.

In the discussion that followed, participants were also able to reflect on the wide range of materials which have been employed in burns treatment historically, from ordinary household items, such as onions and honey, to easy-to-apply pharmaceutical treatments, including tannic acid.

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Reproduced by kind permission of the artist. ©Tom Bailey. Photograph by Jonathan Reinarz.

More recently, collaborations between practitioners, bioengineers and industry have led to the development of expensive, engineered skin substitutes. By not having to harvest skin from elsewhere on their bodies, burns survivors are spared having to endure a series of additional wounds intended to facilitate their recovery.  It was also recognised that with such injuries there were two wounds that were to be overcome before people with burns could even contemplate resuming daily life: there was the physical wound of the burn, but also the psychological one, which often took much longer to heal.

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Reproduced by kind permission of the artist. ©Tom Bailey. Photograph by Jonathan Reinarz.

Finally, while there were many retired medical practitioners present at the Leeds workshop, it was noted that burns treatment has remained unfamiliar to many people, mainly because burns units have often existed as ‘worlds unto themselves’, remaining physically separated from the hospitals in which they are located. At the very least, this project hopes to bring the historical and contemporary work of these units to the attention of a much wider public.

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Reproduced by kind permission of the artist. ©Tom Bailey. Photograph by Jonathan Reinarz.
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