PROGRESS IN A MOSCOW CHILDRENS BURN UNIT - A JOINT RUSSIAN-AMERICAN COLLABORATION

A joint Russian-American paediatric burn programme involving Chiidrens Hospital No. 9 in Moscow and Project HOPE in Millwood, Virginia emerg ed from the efforts of burn professionais from both countries in carin g for a group of children seriously burned as a result of the train-pi peline catastrophe that occurred in June 1989 in the Ural Mountains. T his paper describes the burn unit and its activities during the years 1985-93 and includes: (1) a general description of the physical and ad ministrative structure of the unit; (2) the demography of burn admissi ons; (3) clinical activities; (4) a comparison of the clinical results of the years before the institution of the combined programme (1985-8 9) with those achieved during the first 4 years of the combined collab oration (1990-93). Among the important changes that have occurred sinc e the onset of the combined programme are: (1) overall reduction in th e crude burn mortality rate; (2) decrease in burn deaths in all burn s ize groups; (3) dramatic reduction in the length of stay of children w ith the deepest burns; (4) marked improvement in the take of skin graf ts applied to burn wounds and an almost total elimination of complete skin graft failures.