Cloned skin graft a success

 

A three-year-old South African girl who suffered third-degree burns all over her body is set to recover after a revolutionary cloned skin graft operation, writes BILL CORCORANin Cape Town

THE SOUTH African parents of a toddler who suffered 80 per cent burns to her body were given the news they craved last week when doctors confirmed the rare skin graft surgery performed on their daughter was a success.

Isabella “Pippie” Kruger was given little chance of survival after she suffered third-degree burns last New Year’s Eve to most of her body when a container of lighter fluid her father was holding while at a barbecue exploded, covering her from head to toe.

The three-year-old was admitted to a Johannesburg hospital where, for several months, her injuries left her battling pneumonia and kidney failure.

She also suffered several cardiac arrests before she was considered stable enough to undergo the groundbreaking surgery.

The skin graft procedure used on the child has been performed in the US and Europe in the past, but never before in Africa.

However, on Monday last week doctors confirmed the vast majority of the 41 sheets of skin grown for the child from two small grafts of her own skin – which had been protected from the lighter fluid by her nappy – and stapled to her body had attached as they had hoped.

“Overall we can say it’s a success,” plastic surgeon Dr Ridwan Mia told reporters, before adding there were only isolated islands on the little girl’s body that had yet to attach properly following the surgery that took place a week earlier.

Aside from being the first person in Africa to have her own skin grown artificially for her in a laboratory in the US, the local doctors said the child is also the first to have survived such severe burns in South Africa.

The day she was admitted to hospital, doctors told her parents she would not survive; after the first 24 hours they gave her a 10 per cent chance of pulling through.

The breakthrough surgery is of huge importance to all South Africans given it is estimated that more than 15,000 children in the country, predominately from poorer areas, suffer serious burn injuries each year due to the use of candles, paraffin stoves and open fires.

When doctors decided that the skin graft surgery was a viable option, skin samples from Isabella were sent to Genzyme laboratory in Boston, where they were cloned using mouse cells as a scaffold.

The skin took months to grow and the day before the surgery took place a special courier took the grafts back to South Africa on a flight that took 18 hours.

The skin grafts had to be attached within 24 hours of leaving the US laboratory.

The medical courier delivering the precious cargo was fast-tracked through customs in less than five minutes upon his arrival at Oliver Tambo International airport and, even though he arrived during peak-hour traffic, the skin was at Garden City Hospital in 16 minutes.

Mia and his team then took possession of the skin and began stapling the grafts in pieces on to Isabella’s body. On her face the doctors used absorbent stitch material instead of staples to lessen the chance of scarring.

Following the operation the child was wrapped in foam and protective dressing to ensure she remained free of infection, and she was also sedated to reduce her movement, which could cause the fragile grafts to tear.

Although Isabella will continue to have operations on her body at least until she turns 18, she is now expected to recover.

Isabella’s mother, Anice Kruger, summed up her feelings after getting the good news last Monday by saying: “They gave her a 10 per cent chance of survival and 90 per cent of the skin took – so for me that is a 100 per cent miracle.”

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