Child with burns treated by INTEGRA for the first time in Afghanistan
Mohammad Yousuf born four and a half years ago in HamidUllah’s home who is farmer in a backward district of Ghor province in west of Afghanistan about 1800 km far from Kabul.
Around 6 months ago, Mohammad Yousuf suffered of burns of around half of his body while playing with fire and petrol.
After suffering of burns, the family shifted the child to the provincial hospital where he was admitted for a week and then shifted to Herat regional hospital, and after one day in Herat the child was referred to Indira Gandhi Institute of Child Health (IGICH)Kabul.
While reaching Kabul, the child was in a very serious condition with a 10 kg body weight, suffering of infected burns of face, anterior trunk, posterior trunk, urogenital, buttocks, thighs, and a part of legs and forearms. The patient was admitted to the burn ward on 14/04/1397 where has been continuedly receiving dressings and treatment.
As the patient was in a very serious condition due to deep burns affecting 50% of body his weight, performing a surgical procedure was risky and challenging. Surgeries were delayed various times due to poor condition of the patient. We continued conservative treatment and provided nutritional support (Milk F100) with the help of malnutrition department.
As the patient began to improve and showed positive signs, we tried to graft a part of his body. We covered his back with split thickness graft. The area that was of a paramount significance for us was the patient’s abdominal wall which would have not given us the intended results through split skin graft. The rest of his body could not give us additional full thickness graft. In addition, we could not conduct any other auto graft from his body that could yield results. The only way was the use of a skin substitute, we therefore had to opt for Integra Dermal Regeneration Substitute. We fortunately, had it in stock, it was donated by UCH Zurich.
On 28th November 2018, the child was planned for surgery, granulation tissues of abdomen and a part of scar were excised and replaced by Integra, which was performed for the first time in a child with burns in Afghanistan.After 8 days, during the dressing change, we observed positive result and the Integra was found intact.
At the advice of Prof Clemens, a Swiss Professor of Burn Care and Reconstructive Surgery of UCH Zurich On18th day of Integra application (on December 15th), we applied a split thickness skin graft which was found healed on Day 5.
Dr. Habib ur Rahman Qasim graduated from Medical College of Balkh University in 2000. He obtained his specialisation in pediatric surgery from Indera Gandhi Institute of Child Health in 2007. Subsequently, he has started his professional career as a trainer of specialisation program in the hospital. Considering his qualification and competence, Dr. Qasim was selected as chief of newly established department of Pediatric Burn Care in 2013. He has attended several trainings in burn, plastic and reconstructive surgery realm in USA, India and Switzerland. Dr. Qasim has served for the Afghanistan health system and has had numerous achievements in his specialized profession. In 2017, he was honored to receive the prestigious award of Zorajanzekovic in the World congress for pediatric burns which was held in Birmingham UK.
