Infection hospitalizes Abbott
SAN ANTONIO — Gov. Greg Abbott, whose legs and feet were burned by scalding water in a vacation accident, was admitted Monday to San Antonio Military Medical Center’s burn unit after doctors found he had developed what his office called a “minor infection.”
Abbott will undergo skin grafts under local anesthesia Tuesday to repair burns on both feet. The governor’s office said it expects him to be discharged and return to Austin afterward.
A longtime burn specialist, Dr. Basil Pruitt, a professor of surgery at the University of Texas Health Science Center, called the revelation of an infection worrisome but added, “The fact that they anticipate discharge after application of skin grafts under local anesthesia suggests that it is not heavily infected and that the surgery will not be of a major category.”
Pruitt, who is not treating Abbott, said he didn’t know how deep or widespread the burn is or how it has been treated.
The decision to admit Abbott came after an outpatient visit Monday afternoon at Brooke Army Medical Center, which
serves as the Defense Department’s sole burn treatment facility. Abbott, 58, suffered second- and thirddegree burns to his lower legs and feet in the accident Thursday.
The hospital treats civilians admitted to its emergency room but does not take them for outpatient examinations of burns that are not potentially fatal unless an exception is granted by the secretary of defense or another high-level federal official. That happened in Abbott’s case, SAMMC spokesman Dewey Mitchell said.
The governor’s office has not explained how the accident occurred while Abbott was vacationing at a lodge in Jackson Hole, Wyo. His deputy press secretary, John Wittman, described Monday’s examination as an important “checkup” because “infection is certainly a concern” for Abbott, a paraplegic. Abbott has used a wheelchair since a tree fell on him while jogging in 1984, paralyzing him below the waist.
“As a result of today’s news, and regretfully, Governor Abbott will not be able to attend tomorrow’s memorial service at the Morton H. Meyerson Symphony Center in Dallas,” the governor’s office said in a statement Monday. “In his place, first lady Cecilia Abbott will attend. Further decisions on Governor Abbott’s schedule continue to be day-to-day.”
Hectic trip to Texas
Abbott rushed back to Texas following Thursday night’s sniper shootings that left five police officers dead and nine wounded in Dallas. He appeared at a news conference Friday, and checked into St. David’s Medical Center in Austin the next day. Abbott was being treated there when he took a call from President Barack Obama, who expressed condolences for the loss of the officers.
Abbott did not tell Obama he had been injured, Wittman said.
Though Wittman said the governor is expected to make a full recovery, he did not know if Abbott would attend the upcoming Republican National Convention in Cleveland, saying, “That is still up in the air, as his schedule is day-to-day.”
Much will depend on the extent and depth of his burns, as well as his age. All are factors that affect complications and mortality.
Abbott has suffered burns to two layers of his skin — the epidermis and dermis. Just how much of his skin was burned hasn’t been made public.
The epidermis is the outer layer of the skin and normally a barrier to bacterial invasion. The dermis is a thick layer of living tissue below the epidermis that contains blood capillaries, nerve endings, sweat glands and hair follicles.
Mitchell, the medical center’s spokesman, said the center would have no comment on the governor’s case. Pruitt also declined to speculate on how doctors might control the infection but said the governor was in the right place for care.
Second-degree, or partial-thickness, burns usually have blisters, with the focus of treatment on preventing them from becoming infected. Full-thickness, or third-degree, burns run deeper into the skin and harm the underlying connective tissue between the dermis and fibrous covering of the muscles, preventing healing.
Topical anti-bacterial creams that include Sulfamylon and silver sulfadiazine are used to prevent infection after a burn, but operations are often done to remove damaged or dead tissue when there is more severe injury, said Pruitt, a former longtime commander of the U.S. Army Institute of Surgical Research, which pioneered advances in burn care that have dramatically reduced deaths due to infections.
Advanced treatments
Skin grafts are applied to improve the way the injured area looks and functions. Microcyrstalline silver nylon fabrics are often applied to the burn.
The combination of cutting out dead or dying tissue and using anti-bacterial ointments and nylon fabrics soaked in silver nanoparticles, developed in part by the Institute of Surgical Research during the 1960s and 1970s, has led to “a tenfold reduction in the occurrence of invasive infection as a cause of death in burn patients,” Pruitt said.
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