Treatments & Research

Where Hope and Healing Come Together

Leufry received laser treatment for burns at the Boston Shriners Hospital.
Leufry received laser treatment for burns at the Boston Shriners Hospital (pictured with Matthias B. Donelan, M.D., left).

Innovative approaches to care for burns and cleft lip and palate are changing lives

Children and families find hope, compassion and excellent care for complex medical conditions at Shriners Hospitals for Children. Every day at our locations throughout North America, we are improving lives and helping dreams become realities.

Since opening our first location in Shreveport, Louisiana, in 1922, our hospitals and staff have provided excellent care to the children and families who come to us, regardless of their ability to pay for services.

Today, Shriners Hospitals for Children is one of the largest pediatric sub-specialty health care systems in the world, with a dedicated, full-time staff of experienced pediatric surgeons, therapists and clinicians.

Here are just a few examples of our innovation and dedication.

Advanced laser medicine to treat burn injuries

At Shriners Hospitals for Children — Boston, patients like Leufry, a teenager from the Dominican Republic who sustained burns over 30% of his body at the age of 6, when a live high-tension wire fell on him, are experiencing incredible outcomes with fewer trips to the operating room thanks to advances in laser medicine. Many of these laser techniques have been pioneered by plastic surgeons at the Boston Shriners Hospital.

It’s common practice in burn care to cover a burn wound with skin grafts taken from an unburned part of the body. It’s a highly effective treatment, but the recovery can be painful and the area where the graft is taken, known as the donor site, is left scarred. Both the grafted area and the donor site can develop thick hypertrophic scars that impair mobility and function, and may create less-than-optimal cosmetic results.

Today, clinical practice is changing. Doctors may recommend allowing some less-severe burns to heal on their own. After healing has occurred, plastic surgeons use laser techniques to minimize hypertrophic scarring and restore the skin to its pre-injury state. In cases where grafting has been necessary and this type of scar develops, lasers are very effective at reducing them and improving the patient’s overall appearance without further surgery.

“Laser medicine decreases hospitalization and does not cause deformity in other parts of the patient’s body,” said Matthias Donelan, M.D., chief of staff, Shriners Hospitals for Children — Boston. “These advances are not only keeping kids out of the operating room, but they are ultimately contributing to better outcomes and a better long-term quality of life for our patients.”

Confidence in cleft lip and palate care

According to the American Cleft Palate – Craniofacial Association (ACPA), only 2% to 5% of families who have a child born with cleft lip and palate have another child born with the condition. When a family from Indiana was given this diagnosis for their second child, Evan, before he was born, Shriners Hospitals for Children — Chicago was the first place they called. The family was already familiar with the hospital and its approach to cleft lip and palate care. It’s where their first child, Terilyn, is receiving care.

While the children typically have their appointments on separate days, the two recently visited the hospital together.

Both children had a day filled with appointments with their team of specialists, including plastic surgeons, speech pathologists, psychologists, audiologists, dental and orthodontic professionals, ENT physicians, nurse practitioners and social work care managers. The Chicago Shriners Hospital is recognized as an ACPA-approved team.

Evan received cleft lip and palate care at Shriners Hospitals for Children in Chicago.

Evan received cleft lip and palate care at Shriners Hospitals for Children in Chicago.

Eighteen-month-old Evan was having his first team visit since healing from his four surgeries in 2018, which included repairs to his palate, lips and nose, along with tubes for his ears. Evan’s mother, April, said the family is pleased with the results of the surgeries.

“We thought Terilyn’s surgery was amazing and she looks beautiful, but Evan’s work was like perfection,” she said. “Even the two little marks on his lip. They are his ‘trademark.’ We tell him that’s the special little stamp you’re going to have for life.”

The team visit included a focus on Evan’s challenges with eating solid foods. Speech language pathologists are working with his parents on this issue. Evan is also receiving weekly therapy at home for his sensory feeding issues. “He is doing well and continues to progress, but it is a very slow process in introducing him to different textures and also understanding the concept of needing to chew his food,” said April.

During this visit, the family and clinicians also discussed the future care expected for Terilyn, now 6. “Her next surgery will be a bone graft, but the beginning of that process probably won’t start for a year or so,” said April.

The Chicago Shriners Hospital’s cleft lip and palate team is happy to have played a major role in giving Terilyn and Evan new smiles. David Morris, M.D., a board-certified plastic surgeon, said the parents have played instrumental roles in the process. “It has been a pleasure working with their entire family in so many ways, the most obvious being having met both children as infants, watching them grow, hearing their speech develop, and seeing them interact as siblings,” he said. “As parents, April and Michael have been remarkable in finding ways to support and augment our efforts. Both parents have enthusiastically shared their experiences with other families. This is so important, as the information is coming from the direct experience and the unique perspective of another parent, rather than from the caregiver.”

Interestingly, despite the low percentage of families with more than one child with this condition, our Pasadena, California, location has also provided cleft lip and palate care to a family with multiple children coping with this condition.

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