SPEECH BY DR LAM PIN MIN, SENIOR MINISTER OF STATE FOR HEALTH AT THE 12TH ASIA PACIFIC BURN CONGRESS, AT ACADEMIA, ON 15 AUGUST 2019

Prof Fong Kok Yong, Deputy Group CEO, SingHealth

Dr Chong Si Jack, President, Association for Burn Injuries Singapore and Asia Pacific Burn Association

Associate Professor Ong Yee Siang, Co-chairperson, Asia Pacific Burn Conference

Distinguished Guests

Ladies and Gentlemen

Introduction

1. Good morning. It is my pleasure to join you today at the 12th Asia Pacific Burn Congress. It is a privilege for Singapore to host this signature event and I would like to welcome all the international members of the Asia Pacific Burn Association (APBA). It is noteworthy that the inaugural Congress was held on the grounds of this campus more than 25 years ago, in 1992.

2. The theme “Burn Care Excellence through Multidisciplinary Team Work” is relevant, as the management of burns patients can be complex and requires the expertise of various healthcare professionals including plastic surgeons, critical care nurses, dietitians, therapists, psychologists, medical social workers and medical laboratory scientists. I am heartened to see a diverse mix of local and overseas practitioners coming together at this Congress, to exchange experiences, share best practices, and discuss the latest developments in burns management.

3. In the last decade, advances in burns management, education and research have led to lower incidence of burn-related death and disability in the Asia Pacific¹  region. While we continue to dedicate resources to improve clinical outcomes and support public education and prevention programmes, it is also important to build up capabilities, capacity and research efforts to ensure that our healthcare teams remain well-equipped to manage episodic cases as well as major incidents with a high number of casualties with burn injuries.

Improving Capacities and Capabilities to Manage Burns

4. As the major burns referral centre for Southeast Asia, the national Burn Centre at Singapore General Hospital (SGH) has been providing specialised end-to-end care for patients suffering from major burn injuries, from the point of injury to post-hospital rehabilitation since 1962. Currently, all adult major burns cases²  are conveyed to SGH Burn Centre³ for definitive management. The other acute hospitals may receive a small number of patients with major burns⁴ and the close partnership between SGH Burn Centre and the other hospitals enables these cases to be transferred early to SGH for further management.

5. Among the burn patients that SGH sees, 10 to 15 per cent of them suffer severe burns with more than 30 per cent of Total Burn Surface Area involvement, requiring the patient to undergo skin grafting in order to survive.

6. The national Skin Bank and Laboratory, housed in the SGH Burn Centre, plays a central role in supplying donor skin and culturing the patient’s own skin cells to treat major burn injuries. Since the skin banking programme was set up in 1991, it has established good relations with Hema Quebec in Canada and Euro Skin Bank in the Netherlands to meet the skin graft needs in Singapore.

7. The Ministry of Health (MOH) has recently supported the upgrading of SGH Burn Centre. The expanded facility now has a total of four Intensive Care Unit beds which have been upgraded with anterooms to further improve infection control, as well as ten High-Dependency rooms and isolation rooms, allowing the Centre to maximise care options based on patients’ treatment needs. The two Operating Theatres are also equipped for burn-related surgeries with climate control system to ensure the optimal humidity and temperature during surgery, lowering risk of infection as well as hypothermia due to extensive skin destruction or loss. With the upgrades, the Centre is now better equipped to manage more complex burns scenarios, especially during incidents with high number of casualties suffering from burn injuries.

8. Beyond SGH, MOH also plans to redevelop the burns capability in other hospitals such as KK Women’s and Children’s Hospital (KKH), to improve overall systems capacity for burns management. Currently, all paediatric burns patients are conveyed directly to KKH⁵. The upgrading works in KKH will enhance our paediatric burns management capabilities. Beyond capacity building, MOH will also be supporting burns manpower training and capability building through cross training amongst the institutions and overseas attachments so that staff can familiarise themselves with the burns protocols.

Improving Burns Care through Research

9. MOH also supports research to improve burns care management. For instance, the National Medical Research Council supported SGH Skin Bank, SGH Laboratory and Duke-NUS Medical School in the development of an effective animal-free culture system to grow and expand skin cells for therapeutic skin grafts for burns and chronic wounds. The team is currently working with Health Sciences Authority’s Cell Therapy Facility to manufacture Good Manufacturing Practice grade cultured skin using this new system, in preparation for a clinical trial.

10. Over the years, progress in burns research has improved patient outcomes and quality of life. In 2018, research done at SGH enabled the SGH Burn Centre to introduce a new care protocol using artificial skin to reduce pain for patients with second degree burns. The artificial skin which is made from silicone and nylon interwoven with animal collagen does not need to be changed. It drops off after the patient’s own skin has healed. As a result, the patient requires fewer changes of wound dressing and experiences less pain during the recovery process. The SGH team is now exploring alternative materials to benefit the care of more burns patients.

New Regional Skin Banking Guidelines

11. I am pleased to know that Members of the Asia Pacific Burn Association (or APBA) have jointly developed a standardised set of skin banking guidelines on common safety standards and practices for skin donor screening, recovery, processing, storage and distribution in the region. The first edition of the skin banking guidelines will be released tomorrow by APBA.

12. The guidelines will also serve to facilitate more collaboration between APBA members and expedite the exchange of donated skin during a crisis. I would like to take this opportunity to congratulate the APBA on this significant achievement which will strengthen cross-border cooperation to improve the lives of burn victims.

Closing

13. On this note, let me declare the 12th Asia Pacific Burn Congress open. I wish you all a fruitful and fulfilling experience at the Congress. Thank you.

[1] References: i) Burns. 2009. Changing trends of an endemic trauma; ii) Burns. 2016. The trends of burns epidemiology in a tropical regional burns centre; iii) Burns. 2009. Multi-variate analysis of burns patients in the Singapore General Hospital Burns Centre (2003-2005).

[2] SCDF’s definition of major burns under the trauma standby and diversion protocol is defined as second degree burns affecting >15% BSA or burns in specified areas, i.e. face and/or perineum.

[3] Unless the patient has a cardiac arrest, with airway obstruction or impending respiratory failure. In such cases, the patient will be sent to the nearest emergency department for resuscitation and would only be transferred to SGH Burn Centre after stabilisation.

[4] These cases are likely sent to the nearest hospitals (e.g. NUH, CGH and NTFGH) for stabilisation before being transferred to SGH Burn Centre if they require admission.

[5] Unless the patient has a cardiac arrest, with airway obstruction or impending respiratory failure.