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Dr. Pruitt remembered as a leader in burns, trauma, critical care

Basil A. Pruitt, Jr., MD, FACS—a surgeon-scientist and Second Vice-President of the American College of Surgeons—died March 17 at the age of 88.

Ronald M. Stewart, MD, FACS, Leopoldo C. Cancio, MD, FACS

June 1, 2019

Basil A. Pruitt, Jr., MD, FACS—scientist, surgeon, mentor, and leader—died March 17 at 88 years old. Dr. Pruitt had a major and sustained international impact on the fields of burns, trauma, and surgical critical care. His contributions in these fields were transformational and directly led to dramatic improvements in patient care marked by improved survival, decreased complications, and improved health. His service to the American College of Surgeons (ACS) culminated in his service as Second Vice-President (2016–2017).

Major contributions

  • Integrated laboratory and clinical research, unifying teams of surgeon-scientists and laboratory researchers focused on solving clinically relevant problems
  • Multidisciplinary care of the burn patient, with surgeons, nurses, therapists, and researchers providing care as a team
  • Deployment of the first long-range critical care air transport teams for evacuation of burned combat casualties
  • Topical antimicrobials for the prevention of invasive burn wound infection
  • Infection control in the burn intensive care unit
  • Description of the metabolic and immunologic effects of thermal injury and development of effective nutritional and anabolic strategies
  • Refinement of burn shock resuscitation strategies and identification of the problem of over-resuscitation (fluid creep)
  • Description of the pathophysiology of inhalation injury and treatment with high-frequency percussive ventilation

Education and training

Dr. Pruitt was born in Nyack, NY, to Basil A. Pruitt, Sr., and Myrtle Florence (“Flo”) Knowles Pruitt on August 21, 1930. After graduating from high school in Dallas, TX, he continued his education at Harvard College, Cambridge, MA, graduating in 1952 with a bachelor of science degree in geology. Instead of devoting his future to rocks, to the benefit of so many future patients, he instead chose to go to medical school at Tufts University (class of 1957). While in medical school, he entered into an amazing, lifelong partnership in 1954 when he married Molly Gibson Pruitt.

He began his surgical training at Boston City Hospital under the tutelage of C. Gardner Childs, MD, FACS, and completed his surgical residency at Brooke General Hospital, San Antonio, TX.

Transformational improvements in military and civilian patient care

From 1967 to 1968, Dr. Pruitt served as Chief of Surgery and Chief of Professional Services at the 12th Evacuation Hospital in Cu Chi—the busiest evacuation hospital in Vietnam, where 400−500 major operations were performed each month. He then was appointed Chief of the Trauma Research Team, where he studied the cardiopulmonary responses to injury in combat casualties. Upon his return to the U.S. from Vietnam, Dr. Pruitt became the Commander and Director of the U.S. Army Institute of Surgical Research (USAISR), Fort Sam Houston, TX, where he served for the next 27 years.

He went on to change surgical history by revolutionizing the management of trauma, burn, and critically ill patients worldwide (see sidebar). The cornerstone of these achievements was his successful integration of clinical and laboratory research. Dr. Pruitt’s work as a leader, surgeon, and scientist at the USAISR forged a model in which rigorous scientific inquiry was followed by a dogged translation into dramatic care improvements. This well-polished, multifaceted gem will endure as Dr. Pruitt’s legacy.

Dr. Pruitt retired from the U.S. Army Medical Corps in 1995 and accepted a faculty position as professor of surgery at University of Texas (UT) Health, San Antonio, where he held the Dr. Ferdinand P. Herff Chair in Surgery. At UT Health San Antonio, Dr. Pruitt was viewed as a cherished, respected, and beloved mentor and colleague. He supported the development of hundreds of residents, students, faculty, staff, and leaders. As a faculty member, Dr. Pruitt remained an active contributor to the USAISR, while also serving as the editor-in-chief of the Journal of Trauma for 17 years.

Lifelong innovation, mentorship, and leadership

Although Dr. Pruitt’s research had its roots in the military, the fruits of his labor have been assimilated into civilian medical practice worldwide, with associated significant reductions in both death and complication rates.

Professional Societies led by Dr. Pruitt

  • American Association for the Surgery of Trauma
  • American Burn Association
  • American Surgical Association
  • American Trauma Society
  • Halsted Society
  • International Society for Burn Injuries
  • North American Burn Society
  • Shock Society
  • Southern Surgical Association
  • Surgeons Travel Club
  • Surgical Infection Society
  • Western Surgical Association

Dr. Pruitt received international recognition, with appointments to the National Institutes of Health (NIH) study sections, the Veterans Administration Merit Review Board for Surgery, and the Shriners Hospitals research advisory board and clinical outcomes studies advisory board. He also served as a reviewer for the Hong Kong Research Grants Council, the BC (British Columbia) Health Research Foundation and Alberta Heritage Foundation, and the NIH, serving as a special panel member. During his career, he authored more than 469 peer-reviewed publications, 181 textbook chapters, and 15 books and monographs. Of peer-reviewed articles on burns over the last 55 years, Dr. Pruitt had the largest number of citations.

Perhaps Dr. Pruitt’s most enduring legacy is his mentorship of a cadre of physicians and scientists who have become international leaders in medicine. Among that group are 46 directors of burn centers and units in the U.S. and abroad, 23 department chairs (including departments of surgery, urology, anesthesiology, plastic surgery, pediatric surgery, and medicine), 11 past-presidents of the American Burn Association, 2 past-presidents of the International Society for Burn Injuries, past-presidents of the American Association for the Surgery of Trauma, the Immediate Past-Chair of the ACS Committee on Trauma (COT), and at least 6 of Japan’s academic chairs in the fields of acute care medicine and surgery.

Dr. Pruitt served for 20 years as the associate editor of the Journal of Trauma before he became the editor-in-chief of the publication. Additionally, Dr. Pruitt served as a member of the editorial board of 13 other journals, including two published in China and one in Turkey. He served as an ad-hoc reviewer for an additional 26 journals.

Before he was elected to serve as ACS Second Vice-President, Dr. Pruitt was active on a number of College committees and governing bodies, including the following: Surgical History Group Executive Committee (2016–2018); Program Committee (1987–1990); International Relations Committee (IRC) (member 1982–1993, Chair, 1987–1989); International Guest Scholars Subcommittee of the IRC (member, 1983–1985, Chair, 1985–1987); Advisory Committee, Surgical Education and Self-Assessment Program; Board of Governors (1977–1979), Chair of Nominating Committee of the Board of Governors 1978–1979; and COT (1974–1984). He was recognized by the ACS as the Scudder Orator for Trauma, 1984, and as the Excelsior Surgical Society/Edward D. Churchill Lecturer, 1988.

One measure of his stature and impact is the recognition he received from his peers. Dr. Pruitt was elected to serve as president of 12 surgical societies (see sidebar, this page). His awards included 11 honorary memberships, the Metcalfe Award, the Curtis P. Artz Memorial Award, the Harvey Stuart Allen Distinguished Service Award, the Baron Dominique Larrey Award for Surgical Excellence, the National Safety Council’s Surgeons’ Award for Distinguished Service to Safety, an International Honorary Professorship of Surgery at the Third Military Medical College of the People’s Republic of China, the Danis Award from the Société Internationale de Chirurgie, and the American Surgical Association’s Medallion for Scientific Achievement. In 2000, Dr. Pruitt was recognized with the Distinguished Investigator Award from the American College of Critical Care Medicine, along with the G. Whitaker International Burns Prize. The Tanner-Vandeput-Boswick Burn Prize was awarded to him in 2006. In 2007, he accepted the Roswell Park Medal and received a lifetime achievement award from the Society of University Surgeons. As a co-recipient of the King Faisal International Prize in Medicine in 2008, Dr. Pruitt was honored in Riyadh, Saudi Arabia. In 2010, he received the Lifetime Achievement Award of the American Burn Association; later that same year, he was inducted as the first foreign honorary member of the Japanese Association for Acute Medicine. In 2015, Dr. Pruitt received the Association of Military Surgeons of the United States Lifetime Achievement Award. In 2017, he was honored as an ACS Icon in Surgery. In 2018, Dr. Pruitt received the BioMed SA Lifetime Achievement Award.

Despite all of these honorifics, Dr. Pruitt commented in the ACS Icons of Surgery interview that his main satisfaction came from taking care of patients and witnessing the success of those he had mentored.

Enduring legacy

Dr. Pruitt’s work will have a lasting impact on the care of each patient who will be treated at a burn center or trauma center today, this week, and into the future. But Dr. Pruitt, as a student of the classics, was familiar with the aphorism by Hippocrates: Ars longa, vita brevis (the art is long, but life is short). He would urge us to continue his life’s work—in commitment to science and in service to humanity.

Disclaimer

The opinions or assertions contained herein are the private views of the authors, and are not to be construed as official, or as reflecting the views of the U.S. Department of the Army or the U.S. Department of Defense.