Peruvian Boy's Life Saved Thanks to Radiation Technology

Ebert Tafur had 80 per cent of his skin severely burnt when he arrived at the Cayetano Heredia Hospital's emergency room in February this year. Using the small amount of healthy skin that survived on his body, a group of radiation specialists managed to grow enough new skin to cover his wounds and save him two months later.

"This particular technique saved the boy's life because it's fast," said Rene Herrera Taqua, a doctor at the San Borja National Institute of Child Health (INSN-SB) who treated Tafur, stressing that the time it takes a doctor to grow the skin can be of great consequence. "This is the first successful application of cultivated skin on a patient with critical extensive burns and with minimum probability of survival."

The method they used is called tissue engineering, and it consists of skin cultivation. Scientists develop new tissue from skin biopsy and use scaffolds structures with uneven surfaces for the new cells to grow. With the help of radiation, scientists construct these scaffolds and sterilize them without damaging the growing skin tissue (see The Science box).

"Cultivating skin on a patient who has almost no skin can make the difference between life and death," Rene Herrera said. After having performed nine surgeries on Tafur, doctors thought he wouldn't live as they estimated only a 20 per cent chance of survival.

When Tafur was moved to the INSN-SB's burn unit, a team of specialists with radiation knowledge trained and equipped by the IAEA extracted healthy skin from his ear to grow new skin. By cultivating 2cm of this healthy skin in the tissue engineering laboratory for three weeks, they managed to grow almost 2m which they used to cover his chest and back.

"Skin cultivation is a resource that all of us professionals working with burns should highly value," Rene Herrera said. Other factors that contributed to Tafur's successful recovery were aggressive wound control to avoid infection, early surgeries, antibiotics, nursing care and physiotherapy.

Now, the team is trying to shorten the skin cultivation time by using acellular tissues that would allow doctors to cultivate skin on patients directly, saving even more time and reducing the risk of infection. The Peruvian Institute of Nuclear Energy and the Child Health's Institute of San Borja are planning to collaborate with universities to teach these new techniques.

In the early 1990s, Peru did not have the scientific or technological capacity to develop cells and tissue grafts for skin substitutes to treat this type of tissue loss. The demand for skin substitutes was high and imported material increased the treatment price, making it difficult for low income patients to afford it. Available treatments did not allow doctors to treat patients who suffered burns of more than 55 per cent of their total body surface area. Moreover, these treatments produced scars, which caused survivors psychological harm.

With support from the IAEA, Peru established its tissue bank at the Child's Health Institute in 1996, benefiting from training courses, expert missions, scientific visits and equipment up until today. IAEA experts guided and trained the local staff on the process of tissue engineering and quality management of cell and tissue banks. The Ministry of Health is now investing in a new tissue bank at the adult hospital, Arzobispo Loayza.