A first for medical science

Cape Town 150528. Dr Wayne Kleintjies from Tygerberg hospital performed the world's first autograft( own skin) culture transplanting using hydrophobic dressing to this 16 year old Patient( they said we can't name the patient but use the picture) Picture Cindy waxa.Reporter Sipokazi/Argus.

Cape Town 150528. Dr Wayne Kleintjies from Tygerberg hospital performed the world's first autograft( own skin) culture transplanting using hydrophobic dressing to this 16 year old Patient( they said we can't name the patient but use the picture) Picture Cindy waxa.Reporter Sipokazi/Argus.

Published May 28, 2015

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Cape Town - A home-grown skin grafting technique, which uses a patient’s own skin, could see hundreds of burn victims who are treated in the public health sector benefiting from this life-saving and cost-effective culture transplant.

In what has been described as a “bold and innovative breakthrough by provincial health authorities”, a Tygerberg Hospital doctor has performed the world’s first successful “autograft” culture transplant on two severely burnt patients using a special technique which he developed.

Tygerberg is one of two, and the only adult, burns units in the province. Burns patients often have a bleak prognosis, with long and painful stays in hospital.

Addressing the media on Wednesday, Dr Wayne Kleintjes, the head of the adult burns unit at that hospital and lecturer in surgical sciences at Stellenbosch University, said while the technique was similar to other existing skin-graft techniques, the culture method his team developed differed from conventional techniques.

His technique was not only performed with relative simplicity, but its effectiveness, cost and biological safety made it unique.

While a similar skin transplant was done on a Limpopo toddler, Pippie Kruger, more than two years ago when her own skin was grown in a US laboratory using Epicel technology to grow skin cells from her healthy skin, Kleintjes said the difference with his technique was that the skin of burn victims was done in low-cost settings without the need for expensive laboratory equipment and other animal products.

While in Pippie’s case her skin was grown on a layer of inactive mice cells in an overseas laboratory, in Tygerberg the harvested skin was cultured in a room using the burn victims’ own skin and an incubator to grow the skin cells.

“With our technique there was no radiation facilities or imports required. We just needed to work in a sterile environment, and it proved to be as effective. It was biologically safe and was lifesaving for our patient,” he said.

Kleintjes wouldn’t go into the finer details of the technique as there was a possibility of patenting it to avoid its commercialisation, but he said its modest cost of about R1 000 for each of the two patients he has treated, meant that it would be easily accessible to state patients who couldn’t afford expensive treatments.

Following months of desperation and not knowing how to further treat a 16-year-old burns patient who had a poor prognosis and “was dying a slow death”, Kleintjes said last November he prayed to God to show him how to treat the young boy.

The unnamed boy – a victim of fire from a petrol-bombing incident – was in the hospital’s intensive care unit for three months with no improvement and had lost almost all his muscles. The boy could be treated with Epicel at a cost of R1.8 million, but an import ban placed on the product meant that the doctors wouldn’t be able to access to it even if they raised enough money.

“The only way was to make a plan ourselves. I prayed and asked God for some insight and he gave it to me. Within a few weeks of performing the transplant, the skin graft take rate was 78 percent,” he said.

The 16-year-old was out of ICU within two weeks of receiving the transplant.

Following the successful treatment of the boy, in February this year the technique was also used on a 54-year-old man who also had sustained burns to 63 percent of his body. Following treatment he was also out of the ICU within four weeks.

Health Department head, Dr Beth Engelbrecht, said the ground-breaking technique could change the way serious burns victims were treated in the province.

She said the plan was to patent the technique to prevent profiteering or, should it become commercialised, that it should benefit Stellenbosch University.

Health MEC Nomafrench Mbombo said its cost-effectiveness also placed it within realistic reach of average South Africans.

“Not only would it be affordable for the province, but the accelerated healing of the skin means that patients will spend less time in hospital. Shorter hospital stays will not only reduce hospital-acquired infections, but it will also free hospital beds to allow more patients to be treated,” she said.

Cape Argus

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