Australians injured in the Whakaari/White Island eruption are being treated in Melbourne by one of the world's leading burns specialists but there are fears there may not be enough donor skin.
Adelaide mum and engineer Lisa Dallow, 48, is among the Australians transported out of New Zealand and now in the burns unit at Victoria's Alfred Hospital where she remains in a critical condition.
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Dallow's husband Gavin, 53, died in the blast and his body was earlier found by search teams. The couple's daughter Zoe Hosking, 15, is presumed dead after her body was not initially found.
Gavin's father Brian Dallow, in Adelaide, told media outlet Guardian Australia it was too early to talk about what kind of recovery his daughter-in-law Lisa was looking at.
"All we know is she's in there and severely burned," he said.
"Her brother and her mother are in Melbourne so she will have some support there. So she would be able to go and stay with her parents when she gets out, but that's a long way off."
Lisa is in care of Dr Heather Cleland, a plastic surgeon and director of the Victorian Adult Burns Unit at the Alfred.
The world-renowned expert told Guardian Australia multiple skin grafts would likely be necessary for each patient with severe burns and it might e tough to find enough donated skin.
The media outlet reported a severe burn is considered any burn to more than 20 per cent of the body.
"Once a burn is that size you get the effects of skin damage and loss of it as a barrier function, but it affects other organ functions as well," she said.
"Patients become very unwell and need a lot of supportive care, as well as surgery to remove damaged skin and to replace that with skin that will heal the wound."
She said, generally speaking, it was tough to find enough skin to graft onto a patient with burns to 40 to 50 per cent of their body.
"So they often need multiple trips to surgery for different procedures and multiple skin grafting procedures separated by a few weeks. Patients can be in hospital for weeks or months during the acute stage."
Australia earlier sent 20,000 square centimetres of "allograft" skin to help to New Zealand to help treat eruption survivors.
The skin is collected from deceased donors and cyropreserved.
However, burns and contaminants from ash, steam and smoke complicated the Whakaari/White Island patients' injuries, associate professor Geoffrey Sussman, a wound healing specialist at Monash University, said.
"So when you breathe in steam and smoke of up to 300-degree temperatures, the lungs and breathing are affected as well," he told the media outlet.
"The burns we are talking about from the New Zealand incident are also full thickness burns right down into muscle – even beyond that into tendon and bone. The results are quite horrendous.
He said Australia was lucky to have Cleland's burns specialist team - including some of the world's most "outstanding" specialists in the field - on hand to treat the survivors.
"I have the greatest respect for burns surgeons, the ways they can reconstruct areas and solve what seem like insurmountable problems is nothing short of miraculous."
Patients may also need compression suits to minimise scarring, especially those on joints, which can make it difficult and painful for the patient to move.
"These patients are going to need psychological support, they will need social work support, it will be a whole range of services that they are going to need and there is no doubt that that's one of the major issues [with] serious burns," Sussman said. "The consequences go on for a very long time.
He said Australia's public health system would cover the medical costs but not the ongoing costs for dressings, bandaging, compression suits and moisturisers."