Interface with Dr (Prof) Shrirang Pandit
“Four years ago it was estimated that in India approximately 3-4 patients die due to burn injuries everyday”
…says Dr (Prof) Shrirang Pandit, Plastic Surgery, Bharati Vidyapeeth, Pune. Here, he talks about the prevalence of burn case surgeries and plastic surgeries in India.
It has been a long journey starting in 1977 when I joined the hospital. Over the years I have noticed is that the acceptance of cosmetic surgery is much better now. Previously it was considered to be a social stigma. Further, as far as the burn case surgeries are concerned, the available options have not changed much. Sometimes the offered option is extremely expensive consequently limiting the number of options. The idea is to culture one’s own skin and use it as a graft. But this is very expensive because one needs to have separate laboratories to culture skin. The overall cost gets high in these cases. However, today what has improved is that people now come to hospitals much more quickly. Previously, probably they used to take 3 days to come to the hospital but now they take only 3 hours to come to the hospital. Today, patients are aware that the burnt cases require special care and therefore they visit the hospitals that offer such treatments rather than going to a random hospital. Further, in order to improve the quality of life once the burns are completely healed, proper counseling is done. Burn care has improved as medical care but for patients the goal of looking normal remains elusive.
With respect to burn surgeries, what is India’s position compared to other countries?
In our country we see a lot of suicidal burns where women try to commit suicides. Also, we see a lot of kitchen burns in India. The kitchens are small with small windows; as a result, ventilation becomes an issue causing smoke burns too. And sometimes the smoke kills even when fire does not. This is what marks the difference between us and other developed countries; in other countries burn cases are mostly due to accidents. Second, they are completely covered by insurance. On the other hand, here in India, most of these burns occur in patients with low economic financial status, etc. Thus, for them this medical care becomes expensive. And they go to any hospital where it can be treated similar to other medical problem. No special care is possible.
What is the approximate rate of burn cases in India?
Four years ago it was estimated that in India approximately 3-4 patients die due to burn injuries everyday.
Any incident that you would like to share…
One of my patients was attacked by her mother-in-law, who had thrown kerosene on her. It was a homicidal attack and she had sustained about 65-75 per cent burn. The initial one month was very crucial. I will always say that it is the will power that is very important for bringing about a change.
What kinds of legal issues are involved while dealing with burn cases?
Every burn case is reported to the police. Indeed, a lot of paper work is involved in this matter creating trouble. And patients stay in the hospital for a long time (1-3 months and sometimes even longer). Complicating the matter most of the time is that people are not covered by insurance. Further, sometimes, we do not understand what has happened at the site of accident, which causes issues. Then, there are situations where we will have to take a declaration if the patient wants to say something before he/she succumbs.
What are the risk factors for plastic surgeries? And what is the success rate?
A major part of the plastic surgery is done on people who are born with cleft. With Smile Train, a charitable organisation, we have done these surgeries on about 7,000-8,000 people in last 10 years. Further, for patients who cannot afford these surgeries, we offer free of cost surgeries. Surgeries are also performed on faces met with an accident.
What is the future of cosmetic surgery?
In aesthetic surgeries several new modalities are coming up like radio frequency that can improve the skin quality, and make the face glow. An abundant skin improvement is possible with non-invasive technologies. Sometimes cost becomes a deterrent. There are few social organisations that help in solving this issue. However, I believe that future of cosmetic surgery is very prominent. In the future, the field of cosmetic surgery will grow phenomenally.