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Six people injured in the Honolulu fireworks explosion who were flown to an Arizona burn unit have undergone surgery and are stable, according to the burn center’s director.

The patients, who were some of the most critically injured out of the more than two dozen hurt in the New Year’s Eve blast, arrived Saturday at Luke Air Force Base in Phoenix and were transported to the burn center in six separate ambulances, Dr. Kevin Foster, director of the Diane & Bruce Halle Arizona Burn Center, said Monday during a call with reporters.  

Foster said doctors expect all of the patients to recover, though he cautioned that burn patients are particularly susceptible to infections, which can cause serious complications. He also said the patients will have long-lasting physical limitations, scars and psychological impacts from their injuries. 

“There’s something uniquely and particularly horrifying about being burned, especially from this type of injury, and we anticipate that all of these patients are going to have some adjustment issues,” he said. “I suspect many, if not all of them, are going to end up with post-traumatic stress disorder.”

Foster said the patients are still unconscious and intubated, but doctors are considering waking up a few of them soon. Four of the more seriously injured will likely be in drug-induced comas for weeks before they’re able to be awakened. 

When they do wake up, they will be disoriented, he said, but he expects they will all remember the explosion itself. 

All of the patients are in their 20s and 30s, and many required emergency surgery before they were transported to Arizona. The most seriously hurt has about 80% of their body covered with burns, and the least serious is burned over 45% of their body, Foster said. 

They all have other types of traumatic injuries in addition to the burns. 

“There were a lot of explosions and a lot of particles flying through the air,” he said, “and almost everybody has multiple projectile injuries.”

Neighbors who were at the Keaka Drive house where the explosion occurred said someone lit a firework around midnight that was accidentally angled toward the house when it went off, shooting past dozens of party guests and going into a garage wall where other, still-unused fireworks were stored. 

Police said shortly after midnight, a person attending the party lit an aerial cake in the driveway before it fell on its side, shooting aerials into two crates that contained additional fireworks, according to .

Two women were pronounced dead at the scene, according to Honolulu police, and 23 adults and three juveniles were taken to hospitals in serious or critical condition. One of the critically injured, a 23-year-old woman, died at the hospital early on Jan. 1. 

The Honolulu Medical Examiner’s Office identified her as Jennifer Van. One of the other women who died in the blast was identified as 58-year-old Nelie Ibarra. The third woman who died has not yet been identified. 

Police also announced Monday that a 3-year-old boy died at around 1:30 a.m. at a hospital. City officials identified him as Cassius Ramos-Benigno and said he was at Kapiolani Medical Center for Women and Children. 

A separate fireworks accident on New Year’s Day in Kalihi killed 20-year-old Jayson Ramos.

Doctors expect the six burn patients in Arizona to remain in the hospital for six to 12 months “before they are back to anything closely resembling normal function,” Foster said. 

All underwent surgeries on Sunday, he said. Three had additional surgeries today, and the other three will have more surgeries on Tuesday. 

“By that time, we should have all burns off of people, which is our primary goal,” he said. “And then we start closing the wounds and skin grafting, and that’s what really takes the longest.” 

Foster said closing the wounds is the most time-intensive and dangerous part of recovery because it’s when patients are at the highest risk for infections.

The Arizona Burn Center, one of the country’s largest, has 50 beds, though patients can be housed elsewhere in the hospital if more capacity is needed, Foster said. Right now, the burn center has 10 beds available.

The hospital is also helping family members of the six Hawaii patients with housing arrangements, and some burn center staff members have volunteered to host families in their homes. 

For now, Foster said, the patients are stable. 

“We’re very happy with where we’re at right now,” he said.