Swiss bar fire survivors a month on: ‘My soul needs longer to heal’

At a hospital in Milan, victims of the Crans-Montana blaze share their physical and mental scars — and doctors reveal how they used donated skin to treat the burns

Eleonora Palmieri and her partner embracing in a hospital bed, with bandages on his hand.

Eleonora Palmieri suffered burns to her face and hands in the fire at Le Constellation, which killed 40 people

At the moment the fire broke out in Le Constellation, Eleonora Palmieri and her boyfriend were walking into the Swiss bar, unaware of the disaster unfolding inside.

Entering at the ground floor, the Italian couple were immediately pushed back by people surging up the staircase from the basement where the fire was raging. As Palmieri’s partner was propelled into the street, she was trapped inside by the crowd.

“I will never forget the sudden darkness caused by the dense smoke that filled the room in an instant, making the air unbreathable,” Palmieri, 29, told The Times.

“Then came the light — a tongue of fire that raced up the stairs towards me frighteningly fast, a moment of pure terror in which all my senses were overwhelmed by the heat,” she said.

Footage of a bar on fire with orange flames on the ceiling and a purple light beam.

The blaze ripped through the nightclub at about 1.30am on New Year’s Day

As Palmieri instinctively held up her hands to protect her face, the palms of her hands were horribly burnt.

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“It was a desperate effort to defend myself from the flames,” she said.

Eleonora Palmieri, a Crans Montana fire victim, shows her face covered in burn treatment cream in an Instagram video from the hospital.

Palmieri in hospital and, below, before the fire

As families mourn the 40 victims of the January 1 fire in the ski resort of Crans-Montana, many of those who survived are dealing with life-altering injuries. Of the 116 who were injured, some had burns so horrific they could only be identified by their own families from their fingernails.

Palmieri was one of 12 injured Italians — some with 70 per cent of their bodies burnt — flown by helicopter to Milan’s Niguarda hospital. The Italians were mostly minors, including Manfredi Marcucci, 16, from Rome, who was partying at Le Constellation while on holiday with his family.

“Manfredi was coming up the stairs when the flames hit and he was burnt on his back, arms, shoulders and head — 35 per cent of his body,” said his father, Umberto, who found Manfredi conscious in the snow outside the club. “The dead were being brought out, it was a war zone, but Manfredi didn’t lose consciousness. He had a huge adrenaline rush, knowing he had to survive.”

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Flags from Switzerland, Romania, Italy, Portugal, Belgium, France, and Turkey are displayed with flowers and candles as a tribute to victims of the "Le Constellation" bar fire.

Memorials for the 40 victims of the fire were left outside Le Constellation bar in Crans-Montana
CYRIL ZINGARO/EPA

The teenager arrived at Niguarda in desperate need of skin grafts, which were supplied by the hospital’s skin bank, which had in its freezer 50,000 sq cm of human skin taken from the bodies of donors.

Over the next few days about 20,000 sq cm — equivalent to two large office desks — was used to patch up six of the survivors.

Strips averaging 3cm by 20cm were stapled over burnt flesh, helping seal the wounds to prevent the loss of bodily fluids but also helping the wound breathe and reducing inflammation and pain.

Small holes cut into the donated skin allowed it to stretch to fit neatly over the burns.

“When you lose skin your body sounds the alarm and our skin grafts calm it down, it is like a super plaster — there is still nothing better than human skin,” said Marta Tosca, who runs the skin bank laboratory.

Dr. Marta Tosca processing a skin sample under a laminar flow hood.

Marta Tosca prepares a piece of skin to be grafted on to a patient
ISABELLA DE MADDALENA FOR THE TIMES

The bank survives thanks to donations, receiving 220,000 sq cm of skin last year from 124 donors, and may get more this year as news of its work with Crans-Montana survivors spreads.

Tosca showed The Times where staff smooth out stretches of donated skin, cut them into rectangles and measure and wash them before freezing them at minus 80C.

Manfredi received grafts for his burns but was still extremely weak and used an oxygen mask to breathe.

Like all the survivors, his lungs were affected by inhaling smoke and scalding air at Le Constellation. Six patients were rushed to intensive care to be intubated and attached to ventilators.

Meanwhile, the skin grafts are just the start of a long healing process. Burns can cause the body’s immune system to shut down but after about 15 days it restarts and rejects the donated skin, which disintegrates.

Doctors must then apply grafts with the patient’s own skin, often taken from the thigh, which heals quickly, and sometimes nebulise the skin to create a spray-on graft. If possible, the burnt area is left to reheal itself.

Group photo of the Niguarda Hospital Tissue Bank team, consisting of a male department head and five female biologists.

Giovanni Sesana, front left, leads the tissue bank at Niguarda hospital in Milan
ISABELLA DE MADDALENA FOR THE TIMES

So why use donated skin first if it will be rejected? “We often decide not to take the patient’s own skin at the start because it just creates another wound when they are already suffering,” Tosca said.

Giovanni Sesana, the head of the skin bank, added: “If you put the permanent skin on too soon, before the wound has stabilised, the body may not be ready to take it.”

After the second graft, the patients can face months or years of plastic surgery to remove scarring, he added.

Palmieri dreams of becoming a vet — a future now uncertain due to her wounds. Thanks to her training, however, she was able to reduce the damage done by her burns in the minutes after the fire.

“I was very calm, I knew what was happening to my body. I told my friends to carefully cut off and remove my tights, because I could feel the synthetic fibre was starting to stick to my burnt skin,” she said. She asked for a clean T-shirt to rest her hands on to avoid infection.

Palmieri’s mother, Cristina Ferretti, said her daughter was a “lioness”, adding: “She has been fighting the pain and asked to use her computer immediately [despite the bandages].”

In an interview last week, after she was allowed to move to a hospital closer to her home near Rimini, Palmieri said she was thinking of the New Year’s Eve partygoers who did not make it.

A woman in a winter hat and coat places flowers and lights candles at a memorial.

DENIS BALIBOUSE/REUTERS

“To the relatives of the victims I would like to say my heart is with them. There are no words to soothe such an unjust pain,” she said. “Their memory has become a silent encouragement to never give up.”

On Thursday, she was released but told she has months, if not years, of treatment ahead of her.

Palmieri said she had a message for survivors. “The burns will mark your skin but it’s the soul that needs more time to heal. We must not be ashamed of our fragility or our anger — they are part of the battle. We are a community of warriors linked by a terrible night. We must not let that night define the rest of our lives.”