Profile: John F Burke

18th January 2013

 

Jack Burke was elected an Honorary Fellow of the Royal College of Surgeons of England in 1999. 

He was born July 22 1922 in Chicago where he grew up. He commenced engineering studies at University of Illinois but left after Pearl Harbour and joined the army.  At the end of the war he decided to become a psychiatrist so that he might help men with emotional troubles. But having graduated from Harvard (1951) he trained to become a surgeon and eventually became Professor of Medicine at Harvard Medical School and surgeon to Massachusetts General Hospital.

His election to Honorary Fellowship of the Royal College of Surgeons was in recognition of his contributions to surgery and his close connections with the UK. When he had completed his training in the USA (1960) he was awarded a fellowship to work with Sir Ashley Miles, Director of the Lister Institute in London. He was already interested in surgical infection and during this year at the Lister Institute he performed a number of seminal experiments which demonstrated for the first time that if antibiotics were to be used to prevent infection after surgery then they needed to be given approximately one hour before surgery.  This paper published in 1961 took a little while to be recognized but it completely altered the way in which prophylactic antibiotics were administered in surgery. Now throughout the world prophylactic antibiotics (or as Burke preferred to call them preventative antibiotics) are given before surgery or during the induction of the anaesthesia in all patients at risk of infectious contamination during surgery or those undergoing high risk surgeries. For example in patients undergoing colectomy the incidence of wound infections was reduced by well over 50%.   

He was also interested in the study of metabolic changes after trauma and in particular after severe burn injuries and this gradually became a major activity of this laboratory. In 1965 the Shriners built a children's hospital for burn injuries at the Massachusetts General and Jack Burke was appointed as its first director and chief of surgery. He pioneered the introduction of silver nitrate dressing in the treatment of burns in children and studied the metabolic changes in burns .  He pioneered the adoption of early excision of the deeper burn wounds and their coverage with skin grafts. However in the major burn injury there was insufficient skin that could be harvested from the burnt child, to cover the excised areas and this led him to look for an artificial substitute. He worked with Dr Yannas from Massachusetts Institute of Technology who was Professor of Fibers and Polymers and together they developed an artificial skin consisting of a silicone sheet below which is a layer of collagen as a scaffold for colonized nation by the patient's own cells. It took some nine years to develop Integra which is now used routinely throughout the world in the management of severe burn wound; one of the first examples of tissue engineering.  

Jack was a visiting fellow at Balliol College for a year in 1990- 91. He contributed significantly to the activities of the Nuffield Department of Surgery and lead memorable Grand Rounds on the topic of burn management and treatment of mass casualties. He devoted his year primarily to writing and thinking; he was indeed a lateral thinker, an unusual trait for a surgeon.

He died of pancreatic cancer on November 2, 2011. His surviving family are Aggie, two sons, John and Peter and a daughter Annie, all of whom are successful academics. Another son Andrew died of lymphoma at the age of 13.

 

 

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