26 April 2013

Burn victim undergoes cutting edge procedure

Five-year-old Celiwe Maseko will today undergo a hi-tech skin cloning procedure in Johannesburg.

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 scarring

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 better services

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, Anice Kruger.

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 start

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.  



Read Health24’s Comments Policy

Comment on this story
Comments have been closed for this article.

Ask the Expert

Skin expert

Dr Suretha Kannenberg holds a degree in Medicine and a Masters in Dermatology from the University of Stellenbosch. She is employed as a consultant dermatologist by Stellenbosch University and Tygerberg Academic Hospital, where she is involved in clinical duties and the training of medical students and dermatology residents. Her areas of interest and research include vitiligo, eczema and acne. She also performs limited private practice work in the Northern suburbs of Cape Town in general and cosmetic dermatology.

Still have a question?

Get free advice from our panel of experts

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

* You must accept our condition

Forum Rules