Ms. J a 9 year old girl studying in second standard while playing in a temple at Salem fell down on a burning lamp when someone accidently pushed her. Her clothes caught fire and she sustained burns over her chest, abdomen and partly over her back and both lower limbs. This amounted to 33 % of her total body surface. She was taken to a nearby hospital and treated with dressings initially and then later grafting was attempted. However, the grafting failed and she had extensive wounds also over both thighs. When she came to us 26 days after her burn, she had lost lot of weight, was malnourished and was continuing to lose fluids and proteins through the open wound. We needed to stop this downward spiral and we used skin from our skin bank to cover her wounds. In just few days she made a turnaround and her general condition improved. After her general condition improved we grafted all the raw areas and all her wounds healed and has now gained weight. Behind the smile in her face was the person who kindly donated the skin and the people who helped us get the skin.
Ms. P while crossing the road to go to school met with a major crush and degloving injury over both lower limbs and skin loss over her right elbow. She lost almost all her skin over the left lower limb and most of the skin over the right thigh and upper part of her right leg. In addition to this she had fractures of her pelvic bones, left knee cap( Patella), bones in her left foot as well as a partially dislocated left knee and left ankle. Since she had lost lot of blood her haemoglobin was only 5.6 gms/dl which was very low. As it was a road traffic accident she had a lot of dirt and mud over her wounds. Our first step was to resuscitate her, surgically clean her wounds and stabilise all the fractured bones with an external fixator. For her skin loss, we were now faced with a problem of paucity of donor sites and in such a poor general condition it wouldn’t have been wise to graft her immediately. Left uncovered she would lose lot of fluids, proteins from her body and her wounds would get infected ultimately leading to septicaemia and death. At this juncture, we used the skin from the Ganga skin bank and covered her wounds fully. This prevented infection in the wounds and arrested her protein and fluid loss. After her general condition improved we used a technique called meek grafting wherein a small area of skin was used to cover a large area of wound. She healed well, fractures have united and is now walking. Looking back, she has come a long way. The gamechanger in her management was definitely the donated skin from the skin bank, the skin donor and the people who helped get the skin from the donor. It is they who have made Priya walk.
