Healing is skin deep
Sep 8 2005
By The Evening Chronicle
Doctors in the North East have become the first in the UK to treat young burns victims with "spray-on" skin.
The pioneering treatment is being piloted in the region in a bid to help prevent horrific scarring in children.
Plastic surgeons in Newcastle have been given ethical approval to treat scald injuries with laboratory-grown skin cells.
So far, four children, aged between 18 and 36 months, have benefited in a bid to help reduce their severe scars.
The trials are being carried out at the Burns Centre, based at Newcastle's Royal Victoria Infirmary.
Specialists there are working in partnership with surgeons from the Queen Victoria Hospital, in East Grinstead, West Sussex, who have also been developing the treatment.
It involves taking skin from the patient which is then made into a mesh so that it can cover a larger area. This is then placed over the burn and acts as a lattice, on to which laboratory grown skin cells are sprayed from an aerosol.
Tania Cubison, a specialist registrar, has been spearheading the project, first in East Grinstead and now at Newcastle.
She said: "Burn scarring produces enormous physical and psychological distress for children and their families.
"We hope this treatment may help reduce or even prevent scars in certain incidents.
"We have just started trials in the North East and so far we have been working with four youngsters who have all recently suffered burns.
"It is vital we begin the treatment between 24 and 48 hours of them suffering burns to their body."
Tania and her team are concentrating their trials on young children who have suffered "intermediate" depth burns after accidentally pouring scalding liquids on their bodies.
The Burns Unit in Newcastle sees around 50 cases every year where young children have been hurt after accidents involving boiling water, coffee and tea.
After the injured child is brought into the hospital, a small piece of their skin is removed while the burn dressings are applied in the operating theatre.
Cells are then grown under controlled conditions before being sprayed back on to the youngster two weeks later.
Spraying the cells to any unhealed areas should result in a wound closure by three weeks.
Tania added: "This could result in healing without the development of severe scarring in a large number of children."
During the next 12 months, while treating some of their patients with the new technique, specialists at the RVI Hospital will also be carefully watching a parallel group of youngsters who will be treated by conventional methods.
Children who suffer serious burns are usually treated with skin grafts - where skin is transplanted from other areas of the body.
But the spray-on technique appears to have several advantages.
The method is cheaper, quicker and can be applied to areas such as the soles of feet which are traditionally difficult areas to graft.
But Sarah Pape, consultant plastic surgeon at the hospital, says its effects will have to be monitored closely.
She said: "It will not immediately replace traditional skin grafting.
"Its place in modern surgery has not been established. As far as I'm aware there are no large studies that have measured its advantages over traditional techniques."
The new technique is now being developed to treat other injuries involving large skin loss.
Boy's spray on skin
Connor O'Malley has become one of the first children in the country to be treated with spray-on skin.
The two-year-old, from Jarrow, accidentally pulled a jug of boiling water over himself, leaving him with burns to his arms, back, chest and neck.
His mother, Laura Hope, 19, pictured with Connonr, was left devastated after Connor was taken to South Tyneside District Hospital before being transferred to the Burns Centre at Newcastle's Royal Victoria Infirmary.
Two hours after arriving, in April this year, she was approached by doctors and told about the revolutionary new treatment being tried out.
Laura, from Lulworth Avenue, said: "They explained exactly what the treatment involved and asked if I would agree for it to be tried on Connor.
"It sounded impressive and I was willing to do anything that might have helped my son."
Doctors then proceeded to take a small piece of Connor's skin, which was then used to cultivate a solution of skin cells.
Laura said: "He has had one spray-on treatment so far and he's really recovering well, although he still has a deep scar on his left arm."
Laura, who also has a one-year-old daughter, Demi-Leigh, believes the treatment has helped the family cope during a very traumatic few weeks.
She added: "He's healing really well and the specialists at the Burns Centre have been incredible. I could never thank them enough for what they've done."
In balance
The spray-on skin technique is being carried out by a team at Newcastle's specialist burns centre headed by Tania Cubison.
Earlier this year, the National Burn Care Group proposed a shake-up in specialised care services in the North East and across the country.
It was suggested care should be split intofacilities for minor burns with some plastic surgery, units to handle the majority of injuries and centres to deal with critical cases.
Newcastle would retain burns centre status for adults, while the only specialist centre for children in the North would be in Manchester.
But hospital bosses remain confident the unit will be saved, while anxious parents of burns victims have added their voice in opposing the plans. Public consultation is planned and will be led by the Northern Specialised Commissioning Group, which negotiates specialised services on behalf of primary care trusts in the region.
It has stressed the review into services is continuing and no decisions have been made.
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