Pioneering skin graft for toddler

2012-06-08 00:00

A SOUTH African child who suffered severe burns over most of her body is to get new skin — all the way from the U.S. — on Monday.

Isabella (Pippie) Kruger, suffered third degree burns over 80% of her body when fuel her father was using to start a braai on New Year’s Eve exploded and caused a fireball that engulfed her two metres from the fireplace.

Pippie turns three tomorrow and her mother, Anice Kruger, told sister paper Beeld yesterday: “I wish I could give her a better birthday present, but [the skin] is the best present she will ever get”.

She said Pippie has only three words left: “Mama, Papa and eina”.

Twice a week her wounds are cleaned under anaesthetic, and she has bedsores after more than six months in the high-care unit at Johannesburg’s Garden City clinic.

Anice has been at her daughter’s bedside constantly since the accident, and father Edwin visits at the weekends from the family’s home at Lephalale. The couple’s one-year-old son Arno is staying with his grandparents.

Anice said they would hold a birthday party for Pippie, with balloons and cupcakes. Arno wold be present and would see his sister for the first time since the accident.

Anice herself researched skin regrow after the accident, and tracked down the U.S. company that has grown the skin for Monday’s operation.

The idea became a reality after she met Dr Alan Barrett of Genzyme.

The $87 272 (about R724 000) cost will be covered by a trust fund set up for Pippie, which has received many anonymous donations. “Thank you is not enough to express how grateful my husband and I are,” Anice said.

Antoinette Pienaar

THE skin for the transplant is Pippie’s own skin, which has been grown in a laboratory in the U.S. using a technique not yet available in South Africa.

It will have to be transplanted by Monday evening, no more than 24 hours after it leaves the lab in Boston, Massachusetts.

Plastic surgeon Dr Ridwan Mia said yesterday there had been times that he has battled to control his emotions as he treats Pippie. The worst was when he had to cut dead tissue a centimetre thick from her face.

However, careful wound care has meant that about 40% of her own skin has healed.

Mia said other techniques had been tried in South Africa to regrow skin cells on burn patients, but they have not been very successful. Usually skin grafts are done using skin from the patient’s thighs, but Pippie did not have enough unburnt skin left.

Three weeks ago, ovals of skin were cut from her buttocks and groin and sent in a cooler to the Genzyme laboratory in Boston. There they were cultured on squares of inactive mouse cells, from which the mouse DNA had been removed. This meant that only Pippie’s cells grew.

Genzyme’s Dr Alan Bennett said two seats had been reserved on the flight from Boston to Johannesburg, so that the courier could keep the stainless steel cooler containing the skin with him at all times. Permits were needed under the South African Human Tissues Act to import the skin.

The flight will land at O.R. Tambo at about 5.25 pm and the surgery will begin by 7 pm.

It will take about two hours to transplant the skin, using staples on her body and dissolving stitches on her face, after which Pippie will have to be kept completely still for seven days to allow the grafts to take.

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