Brooke Army Medical Center, 1965: A 6-year-old boy with burns over 35 percent of his body arrives from Guam. The son of a U.S. service member, the child faces a grim prognosis due to an invasive infection.
Desperate to save the boy’s life, Dr. Basil Pruitt Jr. and his surgical team try an unconventional approach. They apply sulfamylon cream, a new anti-infective product colloquially known as Lindberg’s Butter. Later, they remove dead tissue from the child’s body and graft the wound.
The patient not only survives, he also becomes an early beneficiary of a dramatic new treatment for burns pioneered by Pruitt and scientists at the burn center.
“That was a revolution in burn care,” said Pruitt, 88, former commander and director of the U.S. Army Institute of Surgical Research (USAISR) Burn Center. “The occurrence of invasive infection and death dropped from 60 percent to six percent, a 10-fold decrease.”
Other breakthroughs followed. During a medical career that spanned more than a half century, Pruitt spearheaded innovations that helped revolutionize the management of trauma and burns for patients around the world.
Known as a founding father of modern trauma and burn medicine, Pruitt has served as a Clinical Professor of Surgery at UT Health San Antonio since 1995. He will receive the BioMed SA Lifetime Achievement Award on Thursday.
“That gives me a very good feeling,” Pruitt said. “And it certainly justifies the long hours and hard work that has characterized my career to improve the outcome of burned and otherwise injured patients. I took very few vacations, much to my family’s chagrin. I rationalized that as the cost of making these improvements in the care of the critically injured.”
To understand the improvement of burn care in the Pruitt era, consider the data: When Pruitt began practicing in 1959, a 15- to 40-year-old patient with burns over 43 percent of the body had a 50-50 chance of surviving. Today, a patient the same age with the same burns has a 75 percent to 83 percent chance of surviving.
Michael Cowan, a physician and retired Naval Medical Officer, knows who should receive the credit. During a 2015 award presentation in San Antonio from the Association of Military Surgeons of the U.S., Cowan said, “A lot of that improvement has to do with the research and clinical care Dr. Pruitt provided.”
Established in 2005, BioMed SA supports the local health care and bioscience sector. The nonprofit will bestow its first Lifetime Achievement Award on a surgeon who served one year in Vietnam and decades serving the wounded and critically injured.
“Dr. Pruitt’s development of a long-distance transfer system for burn patients during the Vietnam War laid the foundation for the modern Critical Care Transport system used for wounded troops today,” said BioMed SA President Ann Stevens.
“Although his work began in the military, the fruits of his labor have been assimilated into civilian medical practice as well with dramatic reductions, both in deaths and complications. His impact on patient care is simply incomparable.”
Pruitt’s life and practice were shaped in no small way by war. He performed surgery at the 12th Evacuation Hospital, the busiest in Vietnam. On one occasion, his team treated eight troops accidentally napalmed by the Vietnamese. Other horrors remain vivid.
“During [the Tet Offensive], we got rocketed routinely and shell fragments would zing through the operating room,” Pruitt said. “Scared me half to death. Those were my combat casualty credentials.”
Born in Nyack, N.Y., Pruitt grew up like an Army brat as his father, a stockbroker turned oil man, moved the family from state to state with each promotion: Kansas, Iowa, Illinois, Missouri, Minnesota, Texas. Pruitt earned two degrees from Harvard, where he met his wife as a master’s student in geology, and graduated from medical school at Tufts University.
After beginning his surgical residency at Boston University Hospital, he was drafted in 1959. On the advice of a fellow physician, Pruitt asked to serve at the BAMC burn unit. A career was launched.
“That changed my whole life,” Pruitt said.
That 6-year-old burn patient Pruitt treated in 1965? The surgeon recognized dramatic overnight improvement in the child after the new burn cream was applied. More improvement followed after dead tissue was excised. Pruitt monitored his patient’s progress over the years, through multiple skin grafts, until the boy became a man.
“I’ve got a couple of pictures showing the areas that were burned and grafted,” Pruitt said. “He was one of the first of several. The proof [of success] was when it was applied to a number of patients over a period of time, which documented a significant reduction in invasive infection.”
As Pruitt perfected his care and treatment of burns, he shared his innovations with hundreds of physicians. One measure of his influence: Forty-six doctors he mentored became directors of burn centers; 11 became presidents of the American Burn Association. A second measure of his influence: One study of burn literature from 1955-2011 showed Pruitt was cited 2,320 times. The next closest physician was cited 1,829 times.
He remains a consultant at the USAISR Burn Center. His research and advances benefit patients globally. While Pruitt expresses deep satisfaction in his work, he insists that he is but “one father” in burn care, that other physicians and scientists have made significant contributions.
Stevens, the BioMedSA president, acknowledges this as medical fact. But she remains unequivocal in this view: “Dr. Pruitt’s lifetime of achievement puts him in a league of his own.”
Rivard Report photo editor Scott Ball contributed to this story.