Management of burns.

This is the first issue of the Surgical Clinics of North America devoted to burns since 1978. As a third-year medical student that year, I was captivated by this issue, edited by Dr John Boswick. One of the contributors was a young Dr Basil Pruitt, under whom I later had the chance to train at the Army Institute of Surgical Research. The heavily annotated copy still sits on my office bookshelf. Thirty-five years have passed since this last Surgical Clinics of North America issue devoted to burns. During those decades, the field has been transformed. Both concept and practice of early minimally ablative burn excision have been refined. Blood utilization has plummeted. Burn critical care has evolved. Temporary coverage options have expanded. Pain and anxiety control have advanced. Survival has dramatically improved. Survival quality is beginning to be measured, tracked, and optimized. Techniques of reconstruction, rehabilitation, and reintegration have flourished. Overall suffering has diminished. However, many problems persist, some actually exacerbated by the increase in survival after massive burns. Split-thickness autograft remains the standard-of-care for definitive wound closure. Sepsis still kills our patients. Survivors still experience injury and treatment-related pain and fear. Posttraumatic symptoms develop in many. Reconstructive options are limited by available autologous tissue. In this issue of Surgical Clinics of North America, many established and upcoming luminaries in the field share their conceptual and practical knowledge. We’ll review the state of the art in acute and reconstructive surgery, burn resuscitation, critical care, and difficult nonburn problems. We’ll begin with a personal reflection on 70 years of burn care by an older and wiser Dr Basil Pruitt and end with a vision of the important avenues burn research will follow in upcoming decades, written by some of his renowned trainees and collaborators. It has been an honor and a pleasure putting this collection together. I’m grateful to the editors for their confidence in me, to the editorial staff for their generous assistance,