implanting could end pain of skin grafts
Surgeons treating an 11-year-old boy horribly burnt in a playground
attack, have developed a revolutionary treatment which could end
the need for painful skin grafts.
They have found that hair follicles implanted into the synthetic
tissue on wounds can prompt the regrowth of skin. The technique
is quicker than the current method of skin grafts - when skin is
taken from one part of the body and placed on the damaged area.
It will also reduce the suffering of burns victims. At present,
after the pain of the initial accident they undergo skin grafts
which are akin to inflicting deep grazes. Simon Weston, the Falklands
war veteran who received 50 per cent burns and who now campaigns
for fellow burns victims, described it as "fantastic news"
and a breakthrough in the treatment of future victims.
He said: "After the horrendous pain of being burnt, I had
to feel the terrible pain of having healthy skin removed for grafts,
which also increases the risk of infection. If this eradicates the
need for skin grafts, it's an amazing leap in medicine. It might
even mean that they can put hair on the back of my head."
The technique may be used on Alfred, who was set alight allegedly
by a 12-year-old schoolmate in Gillingham, Kent, UK. He suffered
70 per cent burns and so can only have a limited number of skin
grafts. Jim Frame, a consultant burns surgeon, at the St Andrews
Centre in Chelmsford, Essex, UK, who operated on the boy yesterday,
and Naiem Moiemen, another specialist, perfected the technique while
working on the scalp of a badly burnt patient last year.
They wanted to solve one of the biggest problems in treating a
victim who has suffered more than 50 per cent burns - that they
have little healthy skin which can be grafted on to the damaged
area. When skin is badly burnt, the top layer - the epidermis -
and the deeper layer, the dermis, are burnt away along with hair
follicles and sweat glands.
Current skin grafts do not replace these vital structures, and
take up to three months to settle. The surgeons in their quest for
an alternative, decided to use a known synthetic tissue substitute
called "Integra" which is made from shark and cow cartilage.
When placed on top of raw wounds, the synthetic tissue forms a lattice
to allow healthy blood vessels and host cells to grow and become
intertwined with the artifical tissue.
Under current procedures, the use of Integra has to be complemented
by a second operation to provide a graft of skin cover over the
dermis, or deeper layer of skin. The two surgeons decided to see
what would happen if they inserted hair follicles into the new dermis
which had grown into the synthetic product.
Using the technique on the head of a 24-year-old burns victim,
they found that the cells from the hair follicles grew upwards and
provided a new layer of top skin - or epidermis - over the wounded
area. When they examined the results two weeks later they discovered
that the top layer of skin had grown around the hairs. It had covered
the whole of the victim's scalp, without the need for a second operation
to apply a skin graft.
Mr Frame said that the new technique will also be used to give
hair to burns victims. "One of the most impressive aspects
of this new technique was the ease with which hair was able to grow
- growing more than a centimetre in a few weeks. It gives hope to
many people who believed they would never be able to regenerate
hair from burnt skin." He also hopes that sweat glands can
be inserted into the new skin.
The new technique, which was explained to American scientists in
Hawaii in February, will be presented to the British profession
in a medical journal later this year.