Daniel Lyon, 25, who survived the Twisp wildfire that killed three others, has undergone three surgeries and faces skin grafts, physical therapy and pain management, his doctor says.

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The 25-year-old firefighter who survived a deadly blaze last month near Twisp, Okanogan County, faces a future that will require every bit of the grit he showed on the ground, his doctor said Tuesday.

Daniel Lyon has endured three surgeries so far to repair the burns that cover more than 60 percent of his body. But he’ll need additional operations, skin grafts, physical therapy and — importantly — pain management as he continues to heal.

“What his job was is to don his gear and go,” said Dr. Tam N. Pham, the Harborview Medical Center burn expert who is leading Lyon’s care. “To have that kind of valor and selflessness … I think firefighters are special individuals and we’re going to lean on that heavily, if we can.”

Pham joined Lyon’s parents, Daniel and Barbara Lyon, of Puyallup, at a news conference to offer new information about the condition of the first-year firefighter, reserve police officer and avid motorcyclist, hiker and skier.

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Lyon was hurt Aug. 19 when he and three other firefighters were driving up a steep gravel road and crashed down a 40-foot embankment, where they were overtaken by fire, a coroner’s report said.

Killed in the incident were Richard Wheeler, 31; Andrew Zajac, 26; and Tom Zbyszewski, 20; who died of smoke inhalation and burns.

They’re among 59 line-of-duty deaths this year among firefighters, according to a website that monitors deaths and injuries. Sixty-four U.S. firefighters died in 2014, according to the National Fire Protection Association, which also estimates that 65,880 firefighter injuries occur in the line of duty each year, with nearly 30,000 in wildfire operations.

Lyon, who is heavily medicated, can respond to family members, but he doesn’t know about the accident — or the deaths, said his father.

“He hasn’t really asked and we haven’t really told,” he said.

Instead, family, including an older brother and sister, are concentrating on helping Lyon heal. One of the biggest factors so far has been the outpouring of cards, emails and well-wishes from the local community — and beyond, said Barbara Lyon, who has been reading the messages to her son.

“He loves hearing these, he really does,” she said. “Keep them coming.”

Lyon suffered the same types of injuries as the firefighters who died, with burns that aren’t confined to one area of his body, but “all over,” Pham said.

Such widespread burns cause the body to swell and to retain fluid. The early surgeries have been aimed at removing dead tissue, a process known as “debridement,” which prevents infection and boosts the body’s metabolic response.

But replacing the skin lost to the third-degree burns is the next challenge, Pham said.

That will require skin grafts, or thin layers of skin taken from unburned places on the patient’s own body and placed on the wounded areas to heal.

“Our goal is to get him covered by his own skin,” Pham said. “You have to use your own skin. No one else can donate to you.”

Artificial skin products provide only a temporary covering, he added.

Finding places to remove or “harvest” skin grafts is a challenge in someone with such widespread wounds. They’re usually taken from places that aren’t often visible, such as the buttocks or upper thighs, and the areas can be used more than once, burn experts say.

Pham hopes to begin Lyon’s skin grafts within the next week, he said. Doctors sometimes treat severely burned patients with sheets of skin grown from the patient’s own cells, known as a cultured epithelial autograft, or CEA. So far, Lyon hasn’t required that treatment, Pham said.

Still, the young man faces other challenges. Infections are a primary worry for burn patients, both wound infections and problems such as pneumonia, Pham said.

Despite the crush of well-wishers who have asked to see Lyon, his visits have been limited to family, mostly to lower the infection risk.

There are concerns about Lyon’s appearance in the future. But Pham said it’s now possible to keep scarring to a minimum.

“There will be some scarring,” he said, but not the type once seen in horror movies. “Complete disfigurement is not in the equation anymore.”

Pain management is a huge hurdle. Burns are among the most painful injuries to treat, Pham said.

“It’s tremendous,” he said. “You have two types of pain: pain that you have all the time, and dressing pain, when dressings are changed. Those are very severe and it requires specialized care.”

In addition to medication, patients can be distracted from the severe pain with virtual-reality devices, studies show. Pham said they hope Lyon will be able to use those soon.

“I think he’s recovering on track,” said Pham, who noted that the first two months are the riskiest. “But it’s still a very serious situation.”

Lyon’s greatest assets are his youth, his health and the team at the Harborview burn center — and his supportive family.

For their part, Lyon’s parents say they’ve faced a steep learning curve and emotions that dip and peak with their son’s progress.

“It sounds like we have a long way to go,” Lyon’s father said.

Well-wishes for the Lyon family

Messages for Daniel Lyon or his family can be sent through the patient email portal(www.uwmedicine.org/patient-resources/email-patient) at UW Medicine.