A history of burn care

If one uses the incontrovertible index of postburn mortality, it is evident that our ability to care for burn patients has improved markedly since World War II. This can be quantified by the lethal area 50 % (that burn size which is lethal for 50 % of a population), which in the immediate postwar era was approximately 40 % of the total body surface area (TBSA) for young adults in the U. S., whereas it increased to approximately 80 % TBSA by the 1990 s [1]. Furthermore, the mortality rate at the Galveston Shrine for children with 80 % TBSA or greater (mean 70 % full-thickness burn size) during 1982 - 96 was only 33 % [2]. What has been responsible for these improved outcomes in burn care? What practices were essential to this growth, and what are the major problems that remain unsolved? In this chapter, we will take as our focal point the fire disaster at the Cocoanut Grove Night Club which took place in Boston in 1942, less than a year after Pearl Harbor.