Groundbreaking: Isabella Kruger, 3, gets new ‘cloned’ skin grafts

Isabella ‘Pippie’ Kruger defied medics after she was seriously injured on New Year’s Eve when a container of fire lighting fluid exploded at her home in Johannesburg during a barbeque.

She suffered 80 per cent burns to her body and doctors feared she may not have survived.

The toddler has been in hospital since New Year’s Eve and earlier this month underwent a groundbreaking operation that saw 41 pieces of skin flown in from America to be grafted onto her back, face, chest, arms and legs.

Doctors have now said that the artificial skin grafts have ‘taken well’ to her body.

According to Surgeon Ridwan Mia, the operation to graft the skin onto Pippie’s body went well.
He said that, while there would be scarring, it should be much less than if normal skin grafts had been carried out.

So far, he added, Pippie’s new skin grafts seem to be taking and the youngster has slowly been woken up from the medically induced coma that she was kept in.

Now that she is awake and doing well, doctors are hopeful that Pippie will be able to return home soon.

Pippie underwent a groundbreaking operation that saw 41 pieces of ‘cloned’ skin, which was flown in from America, grafted onto her back, face, chest, arms and legs.

As part of a highly experimental therapy, the skin was grown in a laboratory in Boston, Massachusetts using cells harvested from Pippie’s body.

The skin, which has to kept at a temperature of 2°C to 8°C, only has a 24-hour shelf life and the flight from America to South Africa took 21 hours.

It was then whisked through customs and arrived at the hospital just 16 minutes after the plane had touched down.

‘Everything went quite smoothly,’ said Dr Ridwan Mia, a plastic and reconstructive surgeon who performed the surgery on Pippie in a Johannesburg hospital.

Dr Mia said he did not hold out much hope for the toddler’s survival when he first met her in January.

‘She had swelled to three times her size from her injuries,’ he said.

Pippie has been in hospital since being admitted in January and during that time has battled pneumonia and kidney failure, as well as suffering several cardiac arrests.

Doctors finally stabilised her so that this week’s complex skin transplant surgery could be carried out.

Dr Mia and his team used enough skin during the surgery to cover a mat and stapled it in pieces onto Pippie’s wounds.

On her face, doctors used absorbent stitch material instead of staples.

The new skinhad been created by cloning two samples of skin taken from one of the few parts of Pippie’s body that escaped injury thanks to a diaper she was wearing at the time of the accident.

The samples were sent to Genzyme laboratory in Boston where the skin was ‘cloned’ using mouse cells as a ‘scaffold’.

The procedure has been used many times in America and Europe, but rarely in Africa, Dr Mia said.

On Monday evening, a special courier arrived from Boston with a stainless steel container carrying about 30 to 40 grafts of Pippie’s new skin.

Thin, delicate and almost transparent, the skin was taken to a Johannesburg hospital by ambulance from the airport.

The skin needed to be grafted onto Pippie within 24 hours of leaving the laboratory.

‘It was like clockwork the way the skin arrived on time,’ said Dr Mia.

As Pippie was wheeled out of the surgery, her father Erwin Kruger expressed his relief to reporters.

‘Everything looks great – it’s fantastic,’ he said.

The little girl’s mother, Anice Kruger, who has been by her daughter’s bedside since the accident, looked equally relieved.

For a week after the operation, Pippie will be wrapped in foam and protective dressing.

She faces two immediate challenges. The first is ensuring that she remains free of infection. The second challenge is to prevent the new skin from sliding off and not taking.

Skin grafts are delicate and prone to tearing. Doctors will have to keep Isabella sedated to minimise the risk of tearing.

Bronwen Jones, founder of the Children of Fire, a local charity dedicated to providing medical treatments for young burn survivors, considers Pippie to be one of the luckier burn victims.

She said survival in South Africa often depends on victims’ proximity to a hospital and whether they are properly equipped.

While there are no reliable statistics, Ms Jones estimates that around 15,000 children are seriously injured every year.

In impoverished areas, the use of candles, paraffin stoves and open fires are often the causes of fire, particularly during the winter months.

Tembisa Hospital, in the Gauteng province of South Africa, currently has 12 children in their burns unit.

In the case of Pippie, access to medical care at an early stage as well as her parent’s ability to raise money through social networking sites have all helped ease the burden.

Dr Mia will be able to tell whether the skin has successfully taken after two weeks but he is optimistic given Isabella’s determination.

‘She is a fighter,’ he said.