Five-year-old Celiwe Maseko, from Kagiso near Krugersdorp,
who was tragically burnt after her dress caught fire, will today undergo the
same hi-tech skin cloning procedure which helped save the life of Isabella
“Pippie” Kruger at the Netcare Garden City Hospital in Johannesburg last year.
Dr Ridwan Mia, the plastic and reconstructive surgeon, who
will operate on Celiwe and is also Pippie’s doctor, says the success of the
surgery which involves using the five-year-old’s own cloned skin, will only be
determined a week after the skin transplant. Celiwe was burnt on her back,
stomach and thighs on 4 January this year after a friend who was playing with
matches accidentally set her dress alight.
Celiwe had severe third degree burns over 35% of her body.
This type of injury is typically treated with grafts from the thighs or
buttocks, according to Dr Mia. However, this results in additional scarring to
the body. In Celiwe’s case this could be avoided through the use of an
autologous skin transplant — or a transplant of skin grown from the patient.
Doctors expect minimal
The cloned skin is thin and transparent and Dr Mia and his
team at Netcare Garden City Hospital hope that the skin on the burnt areas of
Celiwe’s body will grow back with minimum scarring. This will reduce the trauma
she has already suffered as a result of her accident and give her a chance at a
normal life. Dr Mia has confirmed that Celiwe will require a breast transplant
and a number of other follow-up therapies.
“This procedure is an important landmark in the history of
medical science on the African continent,” observes Dr Mia. “It is only the
second time that the operation is being performed in Africa, and the first time
that it is being undertaken on a dark skinned patient.
This surgery has only been performed on a dark skinned
patient on one previous occasion in the history of medicine. Up until now burn
victims have had preciously few options available to them as this form of
treatment was not available.”
Dr Mia says that it is his hope that a laboratory for skin
tissue engineering for burn victims could be established on South African soil
in the not too distant future. “This will greatly reduce the costs of the skin
and will make this procedure accessible to many more South Africans,” he adds.
“With the high number of burns suffered, particularly by young children, this
is greatly needed.
Resources needed to
We certainly have the necessary facilities, technology and
skills available to make it a reality. We are hoping that the success of these
two cases will demonstrate the enormous potential this procedure has locally.”
Celiwe’s cloned skin is being funded through the generosity
of the Pippie’s Gesiggie Foundation, which was established by Pippie’s mother,
Celiwe’s skin, like Pippie’s, was grown at a laboratory at
Genzyme in Boston, Massachusetts. It was cloned from two biopsies, which were
grown over a period of more than two weeks at the laboratory. Dr Mia says the
harvested skin is so thin it is like “glad wrap”, and is only five to eight
layers compared to the 500 or more layers that ordinarily cover a child’s body.
If the transplant takes, however, the number of harvested skin cells multiply
rapidly and go on to repair the burnt areas.
Celiwe’s parents, Brown and Katlego Maseko, say that they
feel privileged that their child is one of the first to benefit from this
procedure in South Africa. “We hope it will give our brave Celiwe a better
quality of life and assist in her recovery.”
“It has been a difficult 106 days for Celiwe and our
family,” says Brown Maseko. “I think Celiwe suffered a great shock and the burn
was very painful at first. As I work in Thabazimbi [in Limpopo province], I
struggle to split my time between my job, visiting Celiwe at the hospital and
also being there for our two-year-old child in Kagiso. Katlego works far from
home in Pretoria, so you can imagine that it has been a challenging time for us
all. She has been my absolute rock through this experience, which has brought
us all closer together.”
How Celiwe’s dress
started to burn
The incident happened when Celiwe was playing at a friend’s
house in Thabazimbi. A child had been flicking burning matches when one landed
on Celiwe’s dress and set it alight. She ran down the street and was found by a
neighbour who doused the fire, but unfortunately Celiwe had already been
seriously burnt. Brown and Katlego say that they hope the family’s experience
will highlight to other parents the dangers of fire and matches.
“You do not expect this type of thing to happen to your
child,” continues Katlego. “It was such a shock to us! Children do not
understand the dangers of fire. As a result of this experience, I encourage
other parents to teach their children about the terrible dangers associated
with fire and to do everything they can to protect and educate their children
on fire safety.”
Dr Mia adds that as we approach winter in South Africa, this
is a message that we should all take to heart. He says that hospitals such as
Netcare Garden City Hospital deal with more burn victims over the winter months
as people try to stay warm. He notes that while children from all communities
get burnt, it is poorer communities who are particularly affected as many
people use fire to warm their homes.
“Tragically children in South Africa become burnt through a
variety of different accidents,” observes Dr Mia. “Some little children have
hot substances dropped on them from the stove while others fall into hot baths.
How accidental fires
Fires may be caused in the home by people knocking over
candles or paraffin lamps, electrical faults or by leaving clothes to dry on a
heater, which subsequently ignite. Sometimes fires are left unattended in the
home and they ignite wood, blankets or other items left near the fireplace. We
should all take steps to avoid such accidents and safeguard our loved ones.”
Jacques du Plessis, managing director of the Netcare
Hospital Division, says that Netcare is very fortunate to have innovative
medical practitioners such as Dr Mia practicing at its facilities. “Dr Mia, Dr
Porai Moshesh, the attending paediatric intensivist, and the staff at the
hospital are to be commended for their bold pioneering spirit,” he adds. “Their
efforts will hopefully open the door for many more South Africans to benefit
from this groundbreaking procedure and make it available to more South Africans
who are desperately in need of it.”
According to Du Plessis, the experienced doctors and staff
at Netcare Garden City Hospital’s closed paediatric ICU, have ensured that the
facility is today top of mind to the people of Johannesburg and even further
afield when it comes to specialised paediatric care.
Sandile Mbele, Netcare Garden City Hospital general manager,
points out that Celiwe has been a delightful young patient who despite her
ordeal is always smiling. “Her strength has been an inspiration to staff whose
hearts she has completely won,” he adds. “We are humbled that parents such as
the Maseko’s entrust their children to our care, which is a great vote of
confidence in the services we provide,” he concludes.