Burn Care, Self-Immolation: Pain And Progress

Editor's Note: A video about burns caused by self-immolation has been removed from this page. Our intent was to spotlight medical aspects of this story, not to trivialize political activity. We regret any confusion or offense this may have caused.

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Within the past year, dozens of people have set themselves on fire in protest of Chinese rule of Tibet. This is the most recent wave in a centuries-old practice of self-immolation, a ritualistic method of suicide often used to draw international attention to political struggles.

As a science writer, that got me thinking about what actually happens to the body when it catches fire and what technological advances in burn treatment await on the horizon. With the help of experts on the cutting edge of burn science and medicine, I attempted to find answers to these questions and more.

CARA SANTA MARIA: Within the past year, dozens of people have set themselves on fire in protest of Chinese rule of Tibet. This is the most recent wave in a centuries-old practice of self-immolation, a ritualistic method of suicide often used to draw international attention to political struggles. That got me thinking about the science behind burn injuries.

NICOLE BERNAL: A lot of times there's an accelerant use, so you have a much deeper, hotter burn. The person's not fighting to stop the burn so you're gonna have a more extensive burn. Any time this kind of severe burn happens, I think initially you're talking about the most excruciating pain that you could ever experience until you get to the deep burn where it's burned the nerves. And then after that the brain does this thing where it shuts itself down.

CSM: That's Dr. Nicole Bernal, director of the UC Irvine Regional Burn Center. I reached out to her to learn more about what happens to the body when it catches fire, and what scientific advances are being made in burn treatment technology.

NB: The burn that happens to the skin basically sets off this chain reaction within the body that releases all these inflammatory mediators and makes you sick. Can get infected which then doubles the insult from the burn to a whole body infection. And what was shown was that if we can get the burns basically cut away (which we do in the operating room) within, the goal is within four days, but if you can get it done within two days, we've been able to improve the survival. The thing to remember with a burn is for every time I cover a burn with a skin graft, I'm creating an equal space that's open that the body has to heal.

CSM: Enter a revolutionary burn care device that sprays the patient's own skin cells over their wounds. And according to Dr. William Dolphin, "regenerative medicine is booming." He told me about this fascinating new device, which improves upon previous methods. Many treatment centers currently use lab-grown epithelial cells to treat burns. But cultured sheets of skin can take between 10 and 30 days to grow, so patients are at increased risk of infection and are often subjected to multiple painful procedures. With this new technology, a small biopsy is taken from the burn victim, and within 20-30 minutes, the cells are enzymatically separated, prepared in solution, and sprayed over the affected area. But Dr. Bernal cautions that can't help patients suffering severe burns.

NB: It's just for the partial thickness burns--so the second, excuse me, second degree burns--meaning these burns would heal on their own. The biggest advantage there is gonna be you're speeding up this healing process, so decreased hospital stays, decreased pain. What'll be interesting is if this can be taken to the next step and be useful for third degree burns which need skin grafting and need to be removed. And I know right now it doesn't but, you know, they're always making advances based on our needs.

CSM: So let's back it up a little. We've all heard of first, second, and third degree burns, but what exactly do these labels mean? Well, first degree burns, like sunburns, only affect the outer layer of skin, called the epidermis. They're usually red, swollen, and painful, but they don't blister, like second degree burns do. And that's because second degree burns are partial thickness burns. They affect both the epidermis and part of the dermis below, the strength layer of your skin. And because the nerves are only irritated, not damaged, second degree burns hurt like hell. But with proper treatment and infection prevention, they aren't terribly dangerous. They're nothing like a third degree burn.

NB: The worst kind of burn (or, I guess second to worst) is the third degree, which we see the most, that need to be skin grafted. And this is, you've burned the skin, you've burned the dermis, and this is the ones we typically say you can't feel because you've burned through the nerves, you've burned through the hair follicles.

CSM: And can you believe there's such a thing as a fourth degree burn? Unfortunately, since self-immolators are making a public demonstration, the flames aren't put out right away, if at all.

NB: There is an entity called a fourth degree burn, and you'll see this where you basically have burned down to the muscle and the bone.

CSM: Scientific advances in burn treatment are helping save the lives of millions of sufferers. Unfortunately, many victims still succumb to infection and death following severe burns. How do you think these advances will affect what the World Health Organization calls a "serious public health problem?" Reach out on Twitter, Facebook, or leave your comment right here on The Huffington Post. Come on, talk nerdy to me!

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