Skin and tissue donations can save hundreds of children a year who die from burns in SA

Almost 230 children die from burns in SA every year. 

This is according to the Transplant Education for Living Legacies (Tell) organisation who are using the National Burn Awareness Week (May 6-12), to raise awareness of the effects that burn wounds have in SA, but especially on children.

They also using the occasion to raise awareness for organ, tissue and skin donation.

Skin grafts, or allograft, are the best method to treat burn wounds and there is no synthetic skin substitute.

Tell MD Stella de Kock said burns are the third-most common cause of accidental deaths among children under 14 years, after motor vehicle accidents and drowning.

“Nearly 230 children die from burns in SA every year. These deaths occur because of the severity of the burns, but more so because there are no effective, affordable synthetic treatment options available to patients.”

There are 23 burns units in SA which can render acute emergency care, with a limited number rendering comprehensive care.

Nelson Mandela Children’s Hospital and Chris Hani Baragwanath Hospital are the leading burn units in the country. According to Tell, the Nelson Mandela Children’s hospital treats about 3,500 children for burns every year. About 1,300 of these are severe.

An overwhelming 98% of children treated for burns are from disadvantaged communities.

According to the Organ Donor Foundation (ODF), without donor skin, burn victims suffer “agonising injuries and often face certain death”.

ODF says uncontrolled veld and shack fires, hot water and chemical burns are the predominant cause of life-threatening burn wounds.

“Skin grafting has been medically recognised as the most effective way to minimise scarring and promote healing of severe burns,” according to the ODF Tissue Bank report.

“Children particularly need skin grafts as a small burn or scald can cover most of their body, and these skin grafts may be life-saving.

“A burn patient with severe burns may need repeated skin grafts from numerous donors before their burns heal sufficiently.

The foundation reports that when skin is donated, only a very thin layer — similar to tissue paper — is removed and the area from which it is retrieved looks like a light graze.

According to De Kock, because children's skin is still developing, it is thinner than an adult's. Their skin will also burn at lower temperatures and more deeply, which means their injuries are often more serious and their burns have long-term effects.

Tell says that sub-Saharan countries have between 300,000 and 17.5-million children under the age of five who sustain burn injuries annually, with fire-related burns the second-largest external cause of death in the region.

“There is overwhelming evidence that these injuries are largely environmentally conditioned and therefore preventable.”

Skin grafts are used to minimise scarring and promote healing.

The graft retains moisture and helps regulate body temperature, it also helps protect the body from bacteria and other harmful elements.

“Burn wounds must be dressed to prevent dehydration and infection. By applying donor skin [an allograft] to burn wounds, the body recognises the skin as human tissue and sees it as the patient’s own and accepts it.

“A skin allograft relieves pain and controls infection more effectively than a collagen dressing.”

The skin allograft can be harvested from the torso, hips, thighs and upper calves of a deceased donor and the graft can be left on the wound for up to two weeks without having to redress the wound during this time, which enables the body to recover.

“The donor skin dries out after two weeks, making it easy to remove.”

Tell's tips for preventing burns and scalds:

• Create a child-safe area at home.
• Keep hot objects out of children’s reach.
• Teach older children how to cook safely.
• Check bathwater temperature.
• Watch children around fireplaces.
• Don't hold your child while working in the kitchen.

In SA a major prohibiting factor is the availability of skin grafts.

According to the ODF, when the time comes it is important that loved ones know if you wish to donate organ and tissue.

The ODF recommends that donors put themselves on the donor list, but just registering as an organ or tissue donor is not enough. One's family members are ultimately the ones who are asked about the possibility of donation, which  cannot take place without their consent.

The ODF says many donors' wishes are not approved because family members may not know their loved one is a donor.

One donor can save the lives of eight people with organ donation and can improve the lives of up to 50 people with tissue donation.

ODF reports that about 5,000 adults and children are awaiting life-saving organ and cornea transplants.

The Tell organisation works to raise awareness for organ and tissue donation and as their acronym hints, they encourage donors to tell their loved ones, and those around them that they are donors. This is so when the time comes their wishes are known.

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