Eighteen-month-old Palestinian toddler Shams Ismail was rushed to the Sheba Medical Center in Israel recently with extensive burns to more than half of her body. Her chances of survival were slim.
For days, Israeli doctors fought to save her life.
Today, she is well on her way to recovery. The team of Israeli doctors used her own skin to save her life.
“Shams is from the Palestinian town of Rantis, and was burned in a house fire six months ago when a heater short-circuited and started a fire in her room while she was sleeping,” says Naomi Hadar, the executive director of the South African Friends of Sheba Medical Center.
Life-saving treatment was administered by the hospital’s renowned national burn unit in Tel HaShomer. Professor Josef Haik, Dr Moti Harats, Dr Gregory Troddler, and Dr Ayelet Di Segni used a state-of-the-art skin bank to treat her, growing new skin with which to replace the burnt surfaces on her body. This was the first time in Israel a skin bank has been used in such an extreme burn case.
“Doctors take a few cells of skin, incubate them under special laboratory conditions, and grow them in larger pieces,” says Hadar. “The girl was so small and so badly burned, taking skin samples was very difficult.” Ismail arrived at the hospital in a terrible state with severe damage to her legs and stomach, with smaller burns on her arms and face.
The team of plastic surgeons used Sheba’s Kauffmann-Green Skin Engineering Laboratory to grow new skin from just millimetres of Ismail’s own remaining healthy skin in a bold attempt at repairing the extensive skin damage. Within 10 days, there was enough new skin to cover the toddler’s burned stomach area.
“By using the patient’s own skin, there’s no resistance to the skin graft,” says Hadar. This treatment comes after years of using other methods, which were not always successful because of lack of skin or the likelihood of rejection. Doctors could cut skin from another part of the patient’s body, stretch it and perform a transplant, but this painful procedure wasn’t an option for patients who didn’t have enough skin left to use. Doctors also tried using skin from cadavers, donors from the victim’s family, and even other mammal species, but the patient’s immune system usually rejected these grafts.
This method entails taking skin cells that can be biopsied and sent off to a laboratory, where they are grown by being fed various nutrients under special conditions. The process can take some time, but eventually, the cells will divide until they’ve created a sheet of skin larger than the original sample.
The procedure was successfully used in 2016 in Germany to treat a seven-year-old who suffered from a genetic disease which left him with open wounds covering 80% of his body. An almost full-body, lab-grown skin transplant saved his life.
“Using one’s own skin to grow additional skin in a laboratory and graft it back onto the body is essentially the best treatment available to burn victims today,” says Haik, who is the director of the burn centre. “When Ismail came to us, she was in a very severe condition with no certainty of survival. Our highly talented team of medical experts was able to treat her with this new method, and now we are beginning a long and hopeful rehabilitation regimen.”
Ismail remains at Sheba Medical Center, receiving regular graft treatment and care from Haik and his team. “The burns forced the amputation of both her legs, and she’ll need intensive plastic surgery,” says Hadar. “Nobody knows exactly how long she will be at the hospital, but it will be a while. At some point, she will be moved to rehab.”
The medical team will ensure that her face and arms show as little damage and scarring as possible, and that she is entirely ready to return home without risk of complications before they discharge her.
Ismail will therefore remain in their care longer than most Palestinian humanitarian medical cases to ensure full recovery and rehabilitation.
Hadar says this form of treatment could revolutionise burn treatment in South Africa, where burns are a crisis. The problem with bringing this treatment to other medical centres, however, is that very few hospitals in the world have dedicated high-tech burn-centre units and staff, as well as the ability to grow human skin for grafting.
Still, there are other innovations in this area that are accessible, and that would have a tremendous impact on local treatment. Says Hadar, “People who are burned know that one of the worst things is changing the dressing – some have to be sedated to have it removed. The Israeli medical industry has developed a special gun to apply a dressing without touching the wound, and which needs to be removed only after the wound has healed.
“Some of the treatments used widely today often cause suffering, unfortunately, but it doesn’t have to be this way. Sheba prides itself on helping patients of all nationalities, races, and religions. We are ready and able to do good in the world. These medical innovations can help so many people.”