By his own admission, Dr. Kevin Sittig is a man who is anxious to get to work each day. As the director of the Burn Unit at LSU Health Sciences Center, Dr. Sittig continuously deals with an aspect of medicine that is often dreaded by interns and avoided by even the most seasoned physicians. Yet, ask Dr. Sittig why he chose this field of specialty, and he is quick to respond with a heartfelt and sincere explanation that can only come from someone who has dedicated the majority of his life's work to caring for the unique medical and surgical needs of burned patients.
    While doing his intern rotation, Dr. Sittig spent one month in the Burn Unit at LSU Medical Center, and there was introduced to his first patient with massive burns. The female patient had Steven-Johnson Syndrome (a severe allergic skin reaction to medication which effected a 100 percent burn over the woman's body surface. Dr. Sittig explains, " I bonded with her eyes--she was intubated and could not speak, but I remember thinking at the time that I could make a difference here." Making a difference for burn survivors is just what Dr. Sitting decided he wanted to make the focus of his medical career, and he has extended his treatment vision to encompass efforts to emotionally heal those patients who have suffered serious burns.
    Patients who are burn survivors bear not only the physical scars to remind themselves and the world of a disfiguring accident or injury, but they have emotional scars as well; ones which do not so easily respond to the science of burn medicine. Beyond that, Dr. Sittig hopes the future will emphasize public education about the unique trauma of burn survivors, and that society ultimately will reach a collective awareness and heightened sensitivity for these special patients.
   Dr. Sittig's medical journey began with undergraduate study at Louisiana State University in Baton Rouge, where he received his B.S. in Zoology in 1979. He attended medical school at LSU School of Medicine in Shreveport, and also completed his surgical residency here. Following that, Sittig opted for a one-year burn fellowship in the newly established Burn Center at LSU, then headed by Dr. Edwin Deitch. Since that time, he has assumed the role of director of the burn unit, but also serves as associate professor of Surgery at the medical school. Effective July 1, Dr. Sittig will become acting chairman of  the Department of Surgery. In addition to his duties on the burn unit, Dr. Sittig also practices some general surgery, and has completed a fellowship in endoscopy. As a member of LSUHSC faculty, Dr. Sittig also takes trauma calls at least twice per month to help LSU maintain it's Level One Trauma Center status.

Burn Center Statistics & Treatment Approaches
    One of only two burn units in the state of Louisiana, the LSUHSC unit sees approximately 1,400 outpatients per year, and cares for an average of 260 inpatients per year. As an outpatient center, it operates 24 hours a day for even minor burns, yet simultaneously houses an intensive care unit for severe and critical burn patients. Noting the changing character of burn medicine over the last several years, Dr. Sittig points to some encouraging statistics. The overall survivability for burn patients has increased dramatically in his 11-year practice, and Dr. Sittig is currently preparing a manuscript for publication to that effect, with a clinical presentation of his adult patients who were more than 75 percent burned and survived. A relatively recent case involved a young man with third-degree burns over 90 percent of his body who survived. Dr. Sittig points out that this particular patient probably would not have lived if his injuries had been 10 years ago.
   Why the improved outlook for burns? "We have realized we have to pay closer attention to nutrition," Dr. Sittig explains, noting there are potentially serious metabolic problems that can result from overfeeding. "Also, we've learned that we cannot wait to act surgically," he says, explaining that now there are "radical decisions made about surgery early in the course of treatment." Surgery most often takes the form of covering the injured skin, either with harvested skin, cultured skin or artificial skin, the latter of which is a surgical development that is limited in use and generally misunderstood, according to Dr. Sittig.
   "There is no question that the use of artificial skin is helpful in mild to moderate burns to small, isolated areas," Dr. Sittig points out, "but its use does not really have any impact on mortality of severe burns." The use of artificial skin is also a two-step operation. Even with these advances, the best prognosis for patients with severe burns still requires the use of cultured skin. This is a process whereby an approximate 2 x 6 centimeter sample of uninjured skin is taken, then sent to a laboratory in Boston, MA, where skin is literally "grown" for that patient over a three to four week period of time. The use of cultured skin in burn medicine has an approximate 20-year history, and, as Dr. Sittig emphasizes, it has had good long-term results, particularly with regard to durability.

  Another dimension that has been added to the modern burn unit is a physical and psychosocial rehabilitation component, where the term "burn survivor" has come to replace the older terminology of "burn victim" in the vernacular of the treatment staff. This is a change of terms that Dr. Sittig hopes will become common usage among the general public, since "survivor" obviously implies success and restored health, while "victim" implies a treatment failure of some degree. "Actually, when I hear someone use the term 'burn victim' today, I assume the patient must have died." Dr. Sittig explains.

Healing the" invisible" scars
  Dealing with the psychological scars of burn survivors has become a top treatment priority for Dr. Sittig, following a true crisis point in his career that was ironically touched off by what could only be described as a tremendous medical success. Early in his career, Dr. Sittig cared for a critically burned nine-year-old boy and restored him, physically, to the best condition possible and was grateful for the boy's survival. However, once the child left the safe confines of the accepting atmosphere of the burn unit, he and his parents were faced with a misunderstanding and cruel public. "I really hit a low spot," Dr. Sittig offers. "I questioned if it would have been better if this child had died...what kind of quality of life was he going to have? What was he going to do for fun?" Finally, the question that Dr. Sittig had to personally face and confront answers for became, "Am I really doing any good?"
   His answer came when Dr. Sittig visited a children's burn camp in Colorado and took along his nine-year-old patient. By agreement with the camp director, no one in attendance at the camp (other than his own patient) was to know that Dr. Sittig was a medical doctor, and certainly not a burn doctor. This gave him the opportunity to observe his young patient, along with many others, in a loving and accepting environment where the focus shifted from their appearance and limitations to their common abilities and interests. Dr. Sittig believes the experience was one which changed him forever. "It healed me. Being able to see those children ride horses, climb trees, break curfew, and do all the things that children do at summer camp, yet without having to be guarded because they were different, really healed me. Those children shared things with me they never would have if they had known I was a doctor, and it truly helped me realize that what I was doing was worthwhile."
  
The Louisiana Burn Camp
    This experience is both the origin of and the reason behind Dr. Sittig's almost contagious enthusiasm about the Louisiana Burn Camp held each year at Camp Alabama in Choudrant, LA. June 11-16, 2000 marked the ninth annual Louisiana Burn Camp for children all over the state between the ages of five and 17. The camp is staffed by counselors who are also burn-unit staff members, as well as firemen, adult burn survivors, and parents of children who have been burned. Such conditions engender a unique healing environment for many others whose lives have been touched by these special patients.
   The Louisiana Burn Camp is made possible every year solely through private donations made to the nonprofit Percy R. Johnson Burn Foundation, and its healing legacy can only be continued with ongoing generosity. Dr. Sittig explains that it costs approximately $350 per child for the week-long camp, and urges individuals or organizations who may be interested in sponsoring a child to contact him personally. "There's no question this has altered the outlook on life for may of these children," adds Dr. Sittig
     The future is promising for even further advancements that will surely increase the survivability and overall prognosis for many more patients with severe burn injuries. However, Dr. Sittig points to a national mindset of the American Burn Association that claims the field has begun to save people beyond the current capability to reconstruct and rehabilitate. For Dr. Sittig, this simply means that there must be more emphasis on education to remove the societal prejudicial barriers that exists for burn survivors. The beginning of the physical healing process may actually be the easiest for the patient, Dr. Sittig points out, since the Burn Unit at LSUHSC is a totally self-contained unit. Dr. Sittig explains that even in this setting, the patients do more for each other emotionally than anything the burn-unit professionals can do, and believes that this is an empathy that can be transferred into the everyday lives of these patients once they are discharged home.
  
This story began with a man who admitted he truly loved his work, even though it is work that many others would reject as depressing or difficult. Indeed, Dr. Sittig seems to draw his energy from his work, and has found unique personal rewards along the way, although it has not been without a price. On call for all burn patients seven days a week, 365 days per year, Dr. Sittig admits he has found it difficult to take even a scheduled week of vacation away from the burn unit. This has been especially true if he believed a patient needed his care in a way that would make a difference in even the immediate future. Occasionally, however, he seeks and finds some downtime at the family camp on Lake Bistineau, where he retreats with wife Terri and their three children. Heralding the therapeutic benefits of mowing 20 acres and gardening, Dr. Sittig explains that this is his favorite escape. Although currently training someone to help with the call rotation, he seems most firm in his resolve to be uncompromising on the level of care he expects each burn patient to receive.
   As this issue goes to press, the Percy R. Johnson Burn Foundation was expected to close on the purchase of a house located a block-and-a-half away from LSUHSC Burn Unit. Although in need of renovation, this home is intended for use by family members of burn patients who need a place to stay. Again, this thinking reflects the obvious and ongoing effort at healing, both physically and emotionally, that the leadership role of Dr. Kevin Sittig has forged. It also reflects a holistic philosophy that assures a solid and promising future in burn care for patients of the region.

	LSU Health Sciences Center - Shreveport Department of Surgery Burn Service
Kevin M. Sittig, MD		Alan B. Marr, MD
Director of Burn Center		Associate Professor of Clinical Surgery VA Med Center

The LSUHSC Regional Burn Center has served North Louisiana and East Texas since 1978. The recently remodeled center is self-contained with six (6) ICU beds, eight (8) additional private and semiprivate beds, its own operating suite, hydrotherapy area and outpatient clinic. Our facility provides a comprehensive, nationally recognized program of care for patients with burn injuries. Our goal focuses on returning patients to their highest level of function and includes the physical, psychological, social and vocational aspects of their lives.
To meet this goal, we use a team approach, applying the expertise of various specialties to the many, interrelated problems associated with burn injuries. The team is directed by a physician burn surgeon and includes nurses, burn wound technicians, occupational and physical therapists, dietitians, social workers and research personnel.
Innovative methods of burn wound coverage such as cultured epithelial autografts are utilized as well as creative rehabilitation devices as depicted by individually designed face masks for scar control through compression therapy.

The Burn Center is very active, with 180 to 220 acute burn admissions and over 2500 outpatients visits per year. The Pediatric admissions range from 30-35% per year, and the average length of stay is 11 days. In addition to the approximately 200 operations performed on acutely burned patients, an average 70 to 80 additional patients receive elective reconstructive surgery each year.
Research protocols are established in the Burn Center, and resident participation is encouraged.

- These materials are excerpted from the LSUHSC Burn Service web page. -