Veneto hospitals in Italy prepared to receive patients injured in an accident in Crans Montana, Switzerland, demonstrating a swift, coordinated response to a potential mass casualty event.
The mobilization began following an alert from Italian Civil Protection, triggering coordination among the nation’s burn centers. On Thursday, Alberto Stefani, President of the Veneto Region, informed the Farnesina (Italy’s Ministry of Foreign Affairs) of the region’s immediate readiness to welcome injured individuals.
The decision to centralize specialized care at Niguarda Hospital in Milan was made on the morning of Saturday, January 3rd. However, Franco Bassetto, director of plastic surgery and the major burns center at the University of Padua Hospital, maintained constant communication with the 12 major burn centers across Italy, ensuring their availability to receive patients.
Treating Severe Burns: A Complex Process
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Understanding the immediate and long-term care required for third-degree burn victims.
“In the most severe cases, third-degree burns, patients were intubated due to the risk of inhalation injury and potential swelling of the respiratory tract, as the accident occurred in a closed environment,” explained Professor Bassetto. “Intubated patients were then transported to hospitals in Switzerland, France, and Italy.” He emphasized that healing from such injuries is a lengthy process, requiring at least two months of intensive care.
“Burn shock is addressed first,” the specialist clarified. “This is a hemodynamic shock resulting from significant fluid loss.” Once stabilized, surgical intervention begins as quickly as possible. The initial step involves removing necrotic tissues, followed by temporary coverage with skin from a Tissue Bank. Reconstruction then commences using skin grafts and flaps. For burns exceeding 20% of the body surface area, third-degree, hospitalization is expected to last at least two months.
Less severe burns, covering less than 10% of the body, typically require shorter recovery times. If there’s no inhalation injury and the burn shock isn’t significant, outpatient treatment is often sufficient, allowing the burns to heal naturally. At the University of Padua, blue light therapy is utilized to accelerate the healing process.
Preparedness and Past Experience
The coordinated response highlights the importance of established protocols for mass casualty events.
“At Padua, we quickly freed up space by making two sub-intensive care beds available, along with a dedicated intensive care bed for intubated patients and eight beds in plastic surgery for those with burns covering less than 20% of their body,” explained Franco Bassetto, professor of plastic surgery, director of the plastic surgery clinic at the University Hospital of Padua, and president of the Italian Society of Reconstructive and Aesthetic Plastic Surgery (SIC).
Padua has prior experience managing large-scale emergencies, described as mass disaster events—catastrophic incidents generating a number of victims and injuries exceeding local capacity. “This occurred during the Viareggio train accident in 2009,” Bassetto recalled. “We welcomed a certain number of people. Mass disasters necessitate a specific organizational structure.”
On the morning of January 1st, a call went out to the 12 major burn centers in Italy, all of which offered their assistance. Niguarda Hospital in Milan was the first to receive patients. Determining the percentage and severity of burns for each patient is crucial, as it dictates the appropriate treatment plan.
Echoes of the Past
The Crans Montana incident resonated deeply with medical personnel, recalling a previous tragedy in Padua.
The events in Crans Montana profoundly affected Bassetto, not only because of the “huge tragedy” but also because they evoked memories of a deeply impactful case in Padua. It was January 5, 1998, a date etched in collective memory: the explosion of the Befana bonfire in Forcellini, which resulted in two fatalities and 40 injuries.
“At the time, I was early in my career,” Bassetto recalled. “It was a disaster; we were occupied for three days and three nights receiving and operating on patients. However, we successfully established a triage system in Padua that allowed us to get all burn victims to the ward.”
