healthmedicinet

• Gillian Mayer’s wounds on right leg failed to heal
• Five weeks later, she was told she needed a skin graft
• Around 37,800 skin grafts are carried out each year in England alone
• A new technique, CelluTome, is an out-patient procedure and does not require surgery or anaesthetic

By

Cara Lee for the Daily Mail

Published:
19:00 EST, 24 November 2014

|
Updated:
20:45 EST, 24 November 2014

1

View
comments

‘It wasn’t that painful, but it left five deep wounds above my ankle,’ said Gillian Mayer of her leg injury

Gillian Mayer was dismayed when wounds on her right leg still hadn’t healed after several weeks.

They’d been caused by a garden ladder toppling over and landing on her leg in August. 

‘It wasn’t that painful, but it left five deep wounds above my ankle,’ says Gillian, 62.

‘The top layer of skin on the wounds had come off so I pushed it back into place and cleaned and dressed the wounds before finishing my gardening and taking my dog for a walk.’

A few days later, on a friend’s advice, she saw her GP, who recommended that the practice nurse dress the wounds, which covered an eight-square-inch area, every week.

After a few weeks, it became apparent they weren’t healing. 

‘It was sore and I was concerned about getting an infection,’ says Gillian, a retired shop worker from Hillingdon, West London.

Because she’d had skin cancer on her neck two years ago, she was already under the care of a plastic surgery team at nearby Mount Vernon Hospital. 

Five weeks after her leg injury, she had a routine appointment there and showed them the wounds.

She was told that she’d need a skin graft — where skin is removed from a ‘donor’ site and transferred to the wound. 

This site is usually the thigh, because it’s fleshy and any scarring is not usually exposed to view.

Around 37,800 skin grafts are carried out each year in England alone. 

They are done for wounds that won’t heal, including surgical wounds, burns, bed sores, diabetic foot ulcers and venous ulcers, which develop as a result of persistently high blood pressure in the leg veins and damage the skin.

When wounds fail to heal, the only options are to undergo further surgery to try to redo the scar or to use a skin graft. 

Grafts are usually offered for larger wounds after four to six weeks if they haven’t healed, says Toby Richards, a consultant vascular surgeon at the Royal Free Hospital and University College Hospital, both in London.

‘It was sore and I was concerned about getting an infection,’ said Gillian of her wounds

Normally a skin graft is an operation done under anaesthetic, which involves cutting skin away from the donor site, taking the top layer, the epidermis, and some of the layer underneath (the dermis). 

The skin is usually ‘shaved off’ the thigh with a sharp knife. This effectively creates another wound, which can be painful and may scar.

‘Unfortunately, it is often the elderly, who have thinner skin making them prone to bruising and cuts, who have wounds that fail to heal, and because their skin is more fragile they also have more problems at the donor site,’ says Mr Richards.

‘It can even mean this new wound fails to heal, making a new problem.’

But Gillian’s nurse suggested a new technique, CelluTome, which is an out-patient procedure and does not require surgery or anaesthetic. 

‘I was told there was a new machine that sucks up a layer of skin from the thigh instead of cutting it out with a knife, then places it on a wound.’ 

The device consists a small ‘head’ the size of a smartphone, which is connected to a control unit via a tube. 

The head is attached to the thigh for 30 to 45 minutes, sometimes longer, with an elastic strap.

The control unit uses heat (it warms the skin to 40c) and slight vacuum pressure to create tiny visible suction blisters on the skin the width of a split pea and 2mm high. 

A fine knife attached to the head then shaves the blisters off in a controlled manner. 

They are the epidermis, which is only a few cells thick so there is minimal discomfort, explains Mr Richards.

A sticky dressing is then placed over the ultra-thin layer of cells to pick them up and then they are transferred to the wound like a plaster.

Once the epidermal cells are placed onto a wound they start to grow and form a layer of skin across the wound. 

This takes four weeks — around the same time as a conventional skin graft takes to fully heal, Mr Richards adds. 

The donor site doesn’t need any dressing because only the epidermis has been taken and it does not scar.

‘I was told there was a new machine that sucks up a layer of skin from the thigh instead of cutting it out with a knife, then places it on a wound,’ said Gillian

Gillian had the procedure last month at the plastic surgery department of the Royal Free, London, one of three centres in Europe using CelluTome. University Hospital of Wales in Cardiff and a hospital in the Netherlands are the others.

‘I felt no pain, and there was no bleeding from the site on my thigh,’ says Gillian. 

‘The whole thing took around an hour-and-a-half, then I left straight away. The donor site healed in less than a week.’

She still has weekly appointments to redress the wounds. Three wounds healed completely after four weeks, leaving the skin just slightly red. 

The other two had become infected, and Gillian needed antibiotics, but they have now almost healed.

• Mel had a brain tumour for 10 years – but didn’t realise…

  Why sleeping naked could cut your risk of diabetes… not to…

• Could coconut oil help fight ageing? High-fat diet could…

Mr Richards says the device has mostly been used for wounds to the lower leg (‘pretibial lacerations’) but is being considered for surgical wounds, as well as venous leg ulcers and diabetic foot ulcers. 

However, it is suitable only for small wounds between the size of a 50p piece and the size of a hand, because that’s how big the device’s head is.

Another patient to benefit is John Zazzera, 84. 

Four years ago, the former taxi driver had a wound from a surgical incision that wouldn’t heal in the middle of his stomach. 

He’d had numerous operations there, including one for a hernia.

Then earlier this year, a nurse told him about CelluTome, and he had the procedure done three months ago.

‘I felt a slight burning when the device was on my thigh, but it was nothing I couldn’t cope with,’ says John, a widower from North London who has two daughters and two granddaughters. 

‘It’s improved significantly — the wound is now 1cm wide compared with 5 in wide before.’

So far, 50 patients in Europe have had CelluTome. Results are very positive, says Mr Richards. 

CelluTome is routinely carried out across the country. The treatment could cost ten times less than a standard skin graft, which usually involves an operation in theatre and a hospital stay of several days

‘Next year, formal trials will compare its efficacy with other treatments, and by the end of next year we hope to pinpoint where and for whom it works best.’

But it will be several years before CelluTome is routinely carried out across the country.

The treatment could cost ten times less than a standard skin graft, which usually involves an operation in theatre and a hospital stay of several days, says Mr Richards. 

A single transfer graft with CelluTome costs £300 to the NHS.

Demetrius Evriviades, a consultant plastic surgeon at Queen Elizabeth Hospital and BMI The Priory Hospital, Birmingham, says: ‘This appears to be a promising technology to help difficult-to-treat small wounds in an outpatient setting, especially for pretibial lacerations in the elderly,’ he says.

‘It can be problematic to perform traditional skin grafts on the elderly, as the donor site may not heal. 

‘And these patients may not be in the best health so they are often not ideal candidates for anaesthetic and surgery.

‘However, I await proper clinical trials to show that it works. I wouldn’t use it until there is evidence of its benefit.’

 

or comment on this article

• Did Mickey Rourke’s opponent take a DIVE during match?

• Are these the mysterious bangs that were heard across the…

• Turn any balloon into a case for your smartphone

• Referee knocked out by elbow during basketball tipoff

• America’s Got Talent star, 12, does amazing Star Spangled…

• Devil’s Island cells look tiny as told by their old ruins

• ‘Brave’ dog freaks out as Star Wars AT-AT approaches

• See what it’s like to be STALKED by a shark

• Stunning view from a suite in the Blue Diamond condos

• What a Turkey! Girl thinks Thanksgiving bird was pregnant

• Star Wars Episode VII trailer painstakingly remade with LEGO

• The Bagley family do Frozen’s Do You Want to Build a…

• Twitter hits back at GOP staffer who called Sasha and Malia…

• EXCLUSIVE: Fighter who lost professional boxing match to…

• Student, 22, who was shot dead by stalker ex-boyfriend in…

• David Beckham in car accident after picking up son Brooklyn…

• Body of missing Ohio State footballer found dead in a…

• Send our jihadis to Devil’s Island! French politician…

• Florida boy, 13, is reunited with his mother after being…

• Artists working with Shia LaBeouf back up claims he was…

• Kate and Wills to get ‘house warming’ visit from the Queen…

• Were mysterious bangs heard all over Britain and in New York…

• Cops who shot 12-year-old boy in the stomach watched him lie…

• Young Queen plotted to stop Margaret becoming regent:…

Find out now