Bashkirian train-gas pipeline disaster: the American military response.

The United States Army Institute of Surgical Research was asked to provide burn care assistance in June 1989 following the explosion of leaking methane/propane gas in the Central Soviet Union, which destroyed two passenger trains and injured 800 passengers. A 17-member burn team flew from San Antonio, Texas, to Ufa, USSR and assisted in the management of 150 burn patients in a general medical-surgical hospital. Early problems included heavily colonized burn wounds, with a microbial flora that demonstrated broad antibiotic resistance. As wound complications were controlled, 28 operative procedures were performed to excise and graft the burn wounds. The recommendations for burn disaster management, based on our experience in Ufa, should be of assistance to other groups that may be asked to provide similar assistance in the future.