The revolutionary treatment — Integra Dermal Regeneration Template (IDRT)  — which doctors in the UK have resorted to for saving terror suspect Kafeel Ahmed’s life, is an artificial, temporary skin substitute which prevents infection and allows a dermis-like layer to grow.

The 27-year-old aeronautical engineer who suffered 90 per cent burns in the Glasgow airport  attack has been in “critical condition” for weeks and sources amongst the doctors treating him had at one point claimed that he will not survive the third degree burns over most of his torso and limbs. But the UK doctors have turned to IDRT to save Kafeel, according to the British tabloid The Sun.

Normal human skin has the epidermis — a layer of cells of skins without any blood vessels and dermis, a collagenous layer which contains nerve endings, sweat glands, blood vessels and hair follicles.

The cause of morbidity in more than 50 per cent burns cases is infection which metaphorically is like a hole in a boat. With 90 per cent burns (as in Kafeel’s case) infection is almost certain, according to Mumbai-based consultant plastic surgeon Dr Kalpesh Gajiwala.

IDRT is a kind of artificial skin substitute used when there’s not much skin available for autologous grafting — where skin from one site is grafted on to another site of the same patient’s body. 

In third degree burns, both epidermis and dermis are completely destroyed. IDRT provides the scaffolding to treat such cases. The silicone helps close the wound and prevent fluid loss.  IDRT creates a thin layer of neo-dermis which is supposed to behave like the dermis and provides a base for the patient’s own epidermis to grow, Dr Gajiwala explained.

The patient’s own epidermis can be cultured in the laboratory as well and applied after the silicone is removed on the neo dermis.

Can a 90 per cent burns patient survive? Doctors say there have been cases worldwide where even 95 per cent burns cases have been saved. But the question is the extent of third degree burns in such cases.
The treatment is rarely used in India due to the cost, which the tabloid has put at £20,000.

THE TREATMENT
*Integra Dermal Regeneration Template is a temporary artificial skin substitute
*It comprises a thick under layer of Bovie Collagen and Glycosamino Glycan (which is made of shark cartilage). Collagen and Glysosamino Glycan are natural components of human skin
*Another thin outer layer is made of silicon
*OIn the case of third degree burns, dead skin and subcutaneous cells need to be removed, after which IRDT is applied
*Removal of dead skin entails blood loss and subsequent opening of blood vessesl which could prove fatal