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SGH BURNS CENTRE
Treating scars
inside and out
The unit has cared for
burn victims in several
high profile disasters
and terrorist attacks
lamie Ee Wen We
ST FILE PHOTO NG SOFt LUAN
Lance Corporal Chow Han Min one of two critically injured local soldiers in the Taiwan
fighter jet crash in 2007 being rushed to the SGH Burns Centre for treatment

Yio Chu Kang MP Seng Han Thong
who was set on fire by a man last Sun
day is making progress at the Singapore
General Hospital s SGH Burns Centre
Intensive Care Unit ICU
He suffered 14 per cent burns to his
body but is now in stable condition He
was taken off the respirator last Friday
and is breathing on his own
It could well be the first time an MP
has been warded at the centre which Is
on the third level of Block 4 in SGH But
the doctors and nurses who work there
are more than ready to put Mr Seng
back on the road to recovery
Their track record includes dealing
with victims from several high profile
incidents over the last decade the Sin
gapore Airlines plane crash in Taipei in
2000 the Ball bombings in 2002 two
terrorist attacks in Indonesia in 2003
and 2005 and the Taiwan military jet
crash in 2007
Even the birth of the centre was dur
ing trying times after the explosion of
Greek tanker Spyros injurong Shipyard
which killed 76 people and injured near
ly 69 It is still considered the worst in
dustrial accident in Singapore
It was chaotic then There was no
specialised burns facility so the Ministry
of Health and SGH saw a need to start
one said Associate Professor Colin
Song SGH s head of department of plas
tic reconstructive and aesthetic surgery
and director of the SGH Burns Centre
Prof Song who has been with SGH
since 1997 and became the head of the
department in 2004 is no stranger to
the limelight
In the past week he has been tasked
to give updates on Mr Seng s condition
Asked if there is stress in treating an
MP he said I would liken it to treating
our national servicemen Everybody is
expecting him to do well You get a lit
tle bit of stress because you know that
everything s got to work well
But it s becoming quite easy be
cause it s almost automatic
As the only major specialised facility
managing major burn injuries in the re
gion the centre with eight doctors 34
nurses and a host of therapists and sup
port staff has been at the forefront of
treatment in major disasters that have
hit the region in the past decade
In October 2000 flight SQ 006
crashed in Taipei killing 83 and leaving
behind 57 injured of whom three were
sent to the centre here
We really felt this was a national dis
aster because the air force was out there
in the interests of our safety We also
had to send our own team to bring our
Singaporeans back said Prof Song
Once the trio arrived in Singapore
they had extensive surgery that lasted
12 hours While they remained in criti
cal condition for days they were eventu
ally nursed back to health
Then came the biggest challenge to
the centre in 2002
During the bombing at Kuta Beach
in Bali considered the deadliest act of
terrorism in Indonesia 15 people with
severe bums were evacuated to the cen
tre with eight admitted to the ICU
Principal scientific officer Alvin
Chua who heads the skin bank unit in
the centre recalls a shortage of cadaver
skin then
Prior to this attack no emergency
had ever called for that massive an
amount of cadaver skin
On Oct 14 2002 when the patients
arrived from Bali there was 9 100 sq cm
of cadaver skin in the skin bank By Oct
18 only about half was left
Fortunately a prior request for substi
tute skin was made to the University of
Texas Southwestern Medical Centre in
the United States which responded by
sending over 20 000 sq cm
Another problem was a shortage of
blood products following the many op
erations performed for victims of the at
tack
That problem was resolved when the
National Blood Bank was able to obtain
more blood at short notice through
blood donation drives and recalling reg
ular donors
With the sudden influx of patients
off duty staff were recalled with addi
tional nurses from other departments
roped in to help The team worked
12 hour shifts in the days following the
attack
Prof Song said It was a time when
we were frantically busy but we were
never at a stage where we were exhaust
ed because managing these major burn
injuries is about putting the organisa
tional aspect of mass casualty treatment
in place
That s the time when the team has
to come through Everybody knows his
role everybody knows his contribution
to the patient s welfare and once you
are working as a team there s no time
to feel fatigued
As many of the patients were foreign
ers American British Swiss French
Irish Canadian and Japanese nurse cli
nician Lee Lay Eng 51 recalled that in
terpreters were brought in
One patient a doctor died af
ter a 24 day ICU stay but the
others survived
Prof Song said
Losing the ones
that we lose we sit
back and have a
deep breath and take
away lessons and try
to better ourselves so
that the next time
around nobody has to
die
He added that there
was a review of the cen
tre s disaster plan after
the 2000 and 2002 ernei

ceiE sci
gencies
In particular the facility was renovat
ed and the number of ICU cubicles was
doubled to nurse eight patients in a cri
sis
When the 2003 Jakarta and 2005 Ball
attacks came the centre was better pre
pared and did not face any further short
age of skin All the 16 patients survived
Throughout the three terrorist at
tacks the centre continued to function
normally admitting patients from Sin
gapore and abroad The 29 bed unit
treats about 93 per cent of all bums cas
es here The rest are admitted to the oth
er hospitals here
Up to a quarter of the 200 patients or
so admitted every year are those consid
ered to have sustained major bums
In the past the burns unit was a de
pressing place to be in said Prof Song
Nurse Lee said The general appear
ance of the wounds can be pretty trau
matic especially if the surface area is
big
It is also not uncommon for patients
to scream in pain
But modern techniques have
changed things Prof Song said patients
now go through skin grafting early in or
der to minimise the setting in of early
life threatening infection and they do
not require as much dressing
Most patients typically go through a
long period of recovery
When it s taking such a long time
they get frustrated They always ask
why so little progress said nurse Lee
Then there is also the disfigurement
and sometimes disability that patients
have to deal with Which is why there
are counsellors and therapists in the cen
tre to work with the patients until they
have fully recovered
Of the success stories from the cen
tre the one of 25 year old Karthigayan
Ramakrishnan seems to be on every
one s lips
He was injured in Taiwan when a
fighter jet crashed into a storeroom on
May 11 2007 The accident killed three
Singapore soldiers and two Taiwanese
pilots
He was among the two soldiers airllft
ed back One died more than two weeks
later but Third Sergeant Ramakrishnan
who was warded for more than six
weeks pulled through
One of the key things the centre is
looking at is to increase its skin dona
tion
From 1998 to 2007 there were only
50 donors Last year there were two
far short of what s needed to treat pa
tients here
Prof Song said More awareness
needs to be created to let people know
of the need for skin
jai iSt tiesph
TYPES OF BURNS
Superficial burns
Involve only the outer layer of the skin that
is the epidermis and are characterised by
redness swelling and tenderness
Examples are mild sunburn or a scald produced
by a splash of hot water
They usually heal well if first aid is given
promptly and do not require medical attention
Partial thickness burns
Penetrate more deeply destroying all the
epidermal layers and extending into the dermis
The skin will look raw and blisters will form
Partial thickness bums affecting more than 30
per cent of the body s surface can be fatal
Full thickness burns
All layers of the skin are burned
There may also be damage to tissue nerves
muscles and blood vessels
Such burns need immediate medical attention
and will usually require specialist treatment
WHAT TO DO WITH
A thermal bum
This involves heat or fire such as when your
clothes catch fire or when you are scalded by hot
water
The first act of thermal burn treatment is to
stop the burning process
In the case of a fire use a wet cloth or blanket
to smother any flames
Run the burned area under cool running water
for 15 minutes or more or apply a cold gel pack
Cover the burned area with a sterile gauze pad
or a clean cloth
An electrical burn
This happens when a current from an electrical
outlet cord or appliance passes through the
body
Switch off the source of electricity to prevent
further electrocution
Check the victim s pulse and breathing If
none is detected perform CPR and rescue
breathing
Cover the burned area with a sterile gauze pad
or a clean non fluffy cloth
A chemical burn
This happens when the skin comes into
contact with strong chemicals like bleach and
thinner
Flush the chemicals off using cool running
water for 15 minutes or more
Remove clothing or jewellery that has been
contaminated by the chemical
Cover the burned area with a dry sterile
dressing or a clean cloth
For all the cases seek medical help If the
burns are deep or extensive
WHAT NOT TO DO
Do not apply ice directly to the burn
Do not break blisters
Do not apply lotions ointments or fat like
butter to the injured area
Information from the Singapore General
Hospital