Commercial skin substitutes for both the epidermis and dermis are also becoming widely available. One epidermal substitute is made of silicone, whereas the dermal varieties can consist of nylon or of collagen taken from cows, pigs or cadavers. Explains Staiano-Coico: "A lot of the dermal substitutes are like scaffolds, so the body can come in and use that matrix to rebuild its own dermis." Eventually, as healing takes place, the artificial structures are absorbed or surgically removed.

The New York burn team abounds with other specialists. Within a day after surgery, a physical therapist visits a burn patient to see whether the injury has affected the fingers, knees, ankles or other joints. If it has, the therapist begins guiding the patient through some simple daily exercises that involve working the joints to prevent natural shrinkage and the resulting loss of flexibility that can occur as the body heals.

Another team member, Joyce Scheimberg, is one of the few social workers to be found in any hospital trauma unit. Yet her presence makes good sense. Since house fires are the most common cause of burns in the U.S., many victims have lost their homes and most of their belongings. Other family members may also have been injured in the blaze. "Everyone who comes in here is an emergency situation," says Scheimberg, who acts as the liaison between the patient and his family, the hospital staff, insurance companies, lawyers, emergency community services and other pertinent agencies. In her role, Scheimberg is all too aware that the burn victim may not recover--or at least may not recover enough to return to the job. "You don't know what the future will bring," she says, "but we at the burn unit are all eternal optimists."

That optimism pervades the New York Hospital-Cornell Medical Center burn unit, and more often than not, it is justified by the sight of recovered burn patients ready once more to lead normal lives.