European Stars And Stripes (Newspaper) - September 8, 1988, Darmstadt, Hesse                                Thursday september 8,19b8 the stars and stripes page3 Sis Lye Ludlw. Spirt. Rill heal without skin grafts. I or. Peter Zellner left says Ralph Schrolder right is luckier shut most of Ibe Ramsten air show bum victims he treated his second degree Burns air show Burn victims face years of treatment by Janet d Acostino medical writer Ludwigshafen West Germany Roland arc Schnur Hisil Ald a few moments before diving for the ground when he saw the italian jets collide at the air show at Ramstein and. He Felt searing heal on his legs As the Jet or pieces of it he s not sure passed Over him. Then he got up and ran for help. The 37-year-old Stuttgart Man suffered  Burns Over 15 percent of his body primarily on the Back of his legs and arms. Hilling the ground probably saved him from More serious injuries or perhaps death he said from his Hospital room at the workers compensation Accident Hospital Here. Arc Schnur s Hospital Roommate Ralph Schroder 21, of pc scr also dived for Coyer after the crash. I thought this can t be happening " Schroder said then i threw myself face lust on he  he escaped with second degree Burns on his legs left Arm and Back. Arc Schnur and Schroder arc luckier than most of the other 20 patients in the Hospital s bum unit one of the Best in Germany. Their Burns will heal on their own without skin grafts said or. Peter Zellner head of the bum department. In addition to the 22 Ludwigshafen patients 141 other people injured in the fiery aug. 28 crash still Are hospitalized in More than 40 hospitals. Many of the 1 patients at the Ludwigshafen Hospital All less than 43 years old face years of painful and tedious medical treatment and a difficult adjustment to their wounds. They will be hospitalized for months. When finally allowed to go Home they will need to return for repealed surgery to repair the disfigurement caused by the Burns. It takes a Long Lime before you can say As a sur Geon i can t do anything More for them said Zell Ner. The hands of Mosi of the severely injured were badly burned because they tried to cover their faces in reaction to the explosions and tire. The Burn of he hands is a special problem because the fingers and joints become contracted and stiff from the scars said Cliner who specializes in hand reconstruction. Unfortunately their hands did not prevent their faces from being burned. Faces also Are difficult to treat and facial scars cannot be covered with clothing Zellner said. The 12 Ludwigshafen patients most severely burned Are in the intensive care unit. And those who survive will remain disfigured despite Zullner s skill As a Plas tic surgeon he said. Eight of the patients in the intensive care unit arc on ventilators. Their blackened Bod ies Are cared for by masked and Robed nurses 24 hours a Day. One Man lost his lower right leg from the crash. A six year old girl whose parents died in the disaster is not expected to live. When the nurse gently pulled Back the metallic color Sheet on the bed the girl s form was barely recognizable As a human body. On the night of the crash patients brought to the Hospital were Given fluids through intravenous lines their skin was cleansed and an antibacterial ointment was applied Zellner said. A bum patient needs fluid to prevent the circulatory system from collapsing and the antibacterial ointment to prevent infection which can cause death in later stages of a bum. Is Lexja w Span Roland Wreschner says his Burns weren t treated until several hours after the rams Cin air show crash. With Burns you re talking about a situation where the body s natural envelope the skin has been destroyed said Robert Clark spokesman for Brooke army medical Center in san Antonio Texas where seven Burn victims from the air show crash have been transferred that envelope is what keeps body fluids in and viruses out so the first priority is to make sure fluid intake is kept constant and that the patient is kept in As sterile an environment As possible Groshner said his bums weren t treated until several hours after the Accident. He wailed at an Aid station no Ramstein for two hour before being transferred to lands Lull army regional medical Center. At the army Hospi Tal he and several other patients again waited for treat ment but grew impatient and asked a bus Driver to Lake them to a nearby German Hospital. They arrived there at about 7 30 p.m., and then were transferred to Ludwigshafen. There Are four degrees of bums defined by heir severity. A first degree bum such As a sunburn is a superficial injury to the epidermis the upper layer of the skin. A second degree bum injures the epidermis and the layer next to it called the dermis. The bum can vary in severity depending on How far it has penetrated the Der mis. A third degree Burn goes through the dermis and into the fat. A fourth degree Burn has injured the ten dons Muscles and Bones said or. Mai Slyven White chief of plastic surgery at the Wiesbaden air Force regional medical Center. A person with second and third degree bums Over 30 percent 10 40 percent of the body is considered seriously injured. Recovery depends on the age and health of the patient. Second degree Burns Are some of the most painful injuries a person can have because the nerve endings Are exposed said or. Susan Briggs a surgeon at the shrines bums Institute in Boston. The shrines Institute has offered free medical care to children burned in the air show crash German hospitals with victims from the air show crash so far have not sent any children to Boston. Burn patients need Large amounts of narcotics to relieve the pain and sometimes need to be put on a ventilator because the Large doses of narcotics suppress breathing Briggs said. The open wounds of a Burn need to be covered As soon As possible either by using temporary coverings such As Atlo Erawls skin from a Corpse or by doing permanent skin grails. Covering the wounds helps prevent infection. Open wounds arc protected from infection with an antibacterial ointment. All Burn wounds eventually arc covered with skin grafts using the patient s own skin White said. Severely burned patients have less in bumped skin for grafting but donor Sites can be used More than once. Doctors also can take a piece of the scarce skin and enlarge it three to six times through a machine that transforms it into a mesh like Sheet. But the mesh will leave a More noticeable scar while said and dead skin or crust forming on the wounds must be removed either surgically or by other methods before the grafting can take place. That can be done by daily cleansing in which the skin just naturally flakes off or it can be done by Dobri Demcil which is removal of the dead skin by using tweezers to actually pick it off Clark said. Dead tissue can also be removed through  Zellner said he would begin taking a Licals who were in stable condition to the operating room later this week to remove the dead skin and apply the temporary coverings. After a Eccl or so the wounds will be covered with permanent skin grafts. But once the wounds arc covered with skin grafts and the Healing begins patients need years of physical rehabilitation and reconstructive surgery. Briggs said former patients treated at the shrines for 90 percent Burns have received treatment for 20 years because of the amount of reconstruction needed. Burn patients need psychological support As Well As treatment of their physical injuries. At shrines a full time staf of psychologists helps people copy who their scars and get on with Pineir lives. Once the patient leaves the protected world of the Hospital Zellner said the Leal problems Start in Pri vate life in social life and in  in la this Ripon. Gulf Iitto Chuck Emch in Washington