Hope in a scarred world

Tevita Tuiono can now play like any other child, but will need further surgery. Photo / Herald on Sunday

The use of artificial skin substitutes in skin grafting has revolutionised the way severe burns patients are treated, according to the National Burns Centre's clinical leader Richard Wong She.

Plastic surgeons treating patients with badly burned bodies have long struggled with how to repair the lower layer of skin (the dermis), which cannot regenerate in the same way as the top layer (the epidermis).

Wong She spent more than a year using a dermis substitute on burns patients in an American hospital. The substitute, Integra, comprises a layer of cow collagen and shark cartilage covered with a removable layer of silicone.

Surgeons have been using the artificial product to cover the exposed burn area on the patient, which encourages blood vessels and other cells to regrow a new layer of dermis.

Once that has happened, the silicone layer is removed and a new much thinner layer of epidermis can be grafted over the top.

Considerably less operations were needed and the risk of ongoing infection, as in six-year-old Tevita Tuiono's case, was considerably reduced. For Tevita, the improvement using the artificial skin treatment meant the difference between "a productive life and a dependent life". Had the artificial skin method been used earlier, it would have short-circuited months of painful skin grafts and ongoing infection, he said.

Some burns patients in past years got "a raw deal" with graft upon graft of donated skin leaving them disfigured.

Wong She said there were probably "other Tevitas" out there . "They can hunt me out if they like."