Zydus Hospital, Ahmedabad, does pathbreaking work in Burn Management across Gujarat

PRNewswire

Ahmedabad (Gujarat) [India], August 4: India faces a high burn burden with an estimated 2.1 million people suffering from injuries, 25,000 mortalities, and 1.4 million disability-adjusted life years (DALYs) annually, making burn injuries a major public health concern. Over the years, Zydus Hospitals' burns and plastic surgery department, led by Dr. Girish Amlani, Sr. Plastic Surgeon, has built a strong track record in severe burn treatment in Ahmedabad, tending to patients across every degree of burn severity from minor, manageable injuries to some of the most extensive cases seen in the state. Among the most severe, the department has treated more than 300 patients with burns covering more than 50% of total body surface area (TBSA) with a >90% survival rate in the last five years alone.

Burn injury treatment begins with understanding the cause of the damage. A burn is a traumatic injury to the skin and deeper tissues caused by external factors such as heat, chemicals, electricity, and radiation. Severity is measured by the percentage of TBSA affected, and risk climbs sharply with size. Burns above the 20% TBSA mark are classified as severe. In children, burns covering more than 10% of the body are considered alarming and call for a referral to a specialised centre. In adults, that threshold sits closer to 20%.

Once burns cross 30% of the body, patients are usually taken to burn ICU care as burn shock, sepsis and fluid loss become equally crucial to manage. At Zydus Ahmedabad, they are usually placed under the care of Dr. Pratibha Dileep, Critical Care and Hospital Infection Control Specialist, and her team, who were instrumental in setting up the Burn ICU. Along with Dr. Chintan Dhebar, Critical Care Specialist, and his team, they closely monitor organ functions, guide antibiotic dosing, and work closely with the Infectious Diseases team. The first three days are the most critical, with the team's focus on airway management, fluid and electrolyte balance, and pain control. "Eventually our attention shifts to reassessing antibiotic dosing, and we send blood samples weekly to screen for infection, and change IV lines as needed," said Dr. Chintan.

Recently, a 40-year-old police officer needed emergency burn treatment in Ahmedabad after being rushed to Zydus Hospital with burns across 65% of his body that affected his chest, both arms, both legs and his back. He was hospitalised for two months and was later readmitted under Dr. Girish Amlani's care for skin grafting for burns. The patient's wounds were managed with daily dressings using calcium alginate, Acticoat (a silver-based antimicrobial dressing) and collagen powder, which help reduce infection risk.

The challenge was that conventional methods alone couldn't cover a burn of that size. To get around this, Dr. Girish used an electric dermatome, a surgical instrument that shaves thin, uniform layers of skin from a donor site, to harvest split-thickness skin grafts without damaging the deeper tissue. The grafts are then passed through a meshing device that perforates them in a fine lattice pattern and uses a meshed skin graft for burns that expands each sheet to three to six times its original size. So a small area of healthy donor skin could be stretched to cover a wound spanning much of the body, while the perforations double as drainage channels that help prevent fluid from pooling beneath the graft.

Similarly, this grafting expertise was utilised differently for some patients who were injured in the 2025 Air India crash in Ahmedabad. Dr. Girish and his team harvested skin grafts from the calf to release finger contractures. Procedure success depends heavily on the doctor's expertise as well as the advanced infrastructure of the hospital. Infection and fluid pooling beneath the graft are two leading causes of graft failure, and a tightly controlled isolation setup at Zydus helped reduce both risks. These measures matter because compromised skin, the body's primary barrier against pathogens, leaves a large wound area especially vulnerable to infection and pathogens. Central line insertions are almost always required in such patients and are replaced weekly, and are used both for monitoring and for rapid fluid resuscitation whenever needed. Blood transfusions become a recurring need as burn size increases, and require close coordination with the pathology team. Albumin is also used to manage the fluid shifts and swelling that follow major burns.

In addition, pediatric burn treatment in Ahmedabad brings its own urgency. Fluid loss remains one of the most serious risks in the early hours after a major burn, and that applies as much to children as to adults, but at a lower threshold. That was the case for a 3-year-old girl who required scald burn treatment in Ahmedabad after falling into a tub of hot water, sustaining burns across 30% of her body. She spent 10 days in the pediatric ICU at Zydus Ahmedabad before being shifted to the ward. "Another pregnant lady with 6-month amenorrhea had come to us with 60% burns. We could save her and her baby, and they both are doing really well," said Dr. Girish.

Burns are classified primarily by their cause and depth. Scald burns, caused by hot liquids or steam, are typically superficial when caused by a brief splash but can go deeper when the skin remains submerged, causing immersion scalding. Flame burns tend to be deeper still, while electrical and chemical burns are both considered severe regardless of the affected surface area. The skin is the body's largest organ and its first line of defence. Once it's breached, patients become vulnerable to infection, rapid fluid loss and, in severe cases, organ dysfunction.

A significant share of the patients arriving at Zydus need electrical burn treatment or chemical burn treatment in Gujarat owing to the state's industrial and chemical manufacturing base that has helped push the hospital towards providing advanced burn care in Gujarat.

Electrical burns are especially deceptive: the surface damage often looks minor, while the real injury runs deep along the current's path through the body. High-voltage current can trigger severe internal swelling that cuts off blood flow to muscles, and severe muscle injury can lead to complications such as acute kidney injury, which is why these cases call for critical care physicians, nephrologists and surgeons working together rather than any one specialist alone. Similarly, upper airway burn injuries that are usually caused by inhaling smoke, direct thermal damage, or chemical irritants released as materials burn may present as only 5-10% burns. Usually, the lining of the lungs is affected, and inhaling smoke leads to absorption of toxins into the bloodstream and, in severe cases, causes respiratory failure that requires ventilator support. Because the airway itself may be swollen or structurally altered, intubation is technically demanding in view of the altered airway structure and is handled only by experienced physicians at Zydus, who work closely with the anaesthesia team.

Dr. Girish and his team, including Dr. Jalpa Mehta and Dr. Priyanshu Makwana, have been doing tremendous work in the field and have treated tens of thousands of burn patients. The team takes pride in handling complete end-to-end wound dressings, which they believe are the reason behind their stellar success rates.

Managing complex cases at this scale requires intensivists and critical care physicians, pain management specialists, physiotherapists and psychologists, and at Zydus, they have cemented their roles in handling a mix of industrial accidents, domestic injuries and mass-casualty situations. Burn rehabilitation, including physiotherapy after burns, continues long after the wounds have healed, and this sort of multidisciplinary burn care is central to patient recovery.

To know about their services, visit https://zydushospitals.com/.

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