Children of Fire
Chest injuries and reconstruction
Children of Fire is looking for a medical student who would investigate different chest and breast reconstruction issues for burns survivors. This research is unpaid but would be of great assistance to many people helped by the charity.
Projects running for six weeks to six months are available. Practical work including watching surgery, would be available. Researchers are welcome to: firechildren@icon.co.za attn: the Director subject: chest burns research
The need to try to reconstruct the chest of a burned child or adult is a common problem in the developing world. Burns are incurred when people are cooking (especially women) and paraffin (kerosene) stoves explode, typically injuring face, hands and chest. Children are involved with cooking from a young age.
And a frequent method by which people attempt suicide is to pour paraffin onto their chests and then to set themselves alight.
When people survive these injuries, they face innumerable problems.
Among those that Children of Fire has helped or continues to help, the girls and young women are most affected. Some have tight meshed skin that means they don’t just avoid swimming costumes but also cool summer tops or pretty neckline dresses. Some are missing one breast entirely and many are missing any trace of a nipple.
They are given contrary advice and little or no counselling. If they are examined at a teaching hospital, while they stand there semi-naked, they also have to endure the added embarrassment of male would-be surgeons giggling over questions like “what is the average nipple diameter” of a young woman in South Africa?
Even those who are lucky enough to have had nipples reconstructed are usually unaware that it is purely aesthetic. The detail is tattooed onto the skin. Sometimes the nipples are not positioned quite centrally and the breasts then look lop-sided. They will never be able to breastfeed and no one has prepared them to ask about tablets to dry up milk production when they one day have a baby. Often it seems that that aspect has not even occurred to the surgeons who rebuilt them. Nor the thought that such tablets may be very hard to source for low-income rural women.
It is another psychological issue to face, when the wonderful mother-child bond of breastfeeding is denied to them for ever. And the next generation suffers not just by missing this bond, but also by missing all the health benefits of breast milk.
So can one rebuild a working breast?
Can surgeons help little burned girls to have a better outcome before they grow into womanhood?
Can surgeons stop using meshed skin on parts of the body that are so critical to a person’s self esteem?
Case history:
Her surgeon writes: Ms K’s nipples were burned off with the deep breast burn at the age of ten years. The skin over her breasts was burned off after a stove exploded. What is there now is scar tissue. Her areola and nipple were reconstructed on each breast from skin grafts and her nipples were reconstructed from the skin put up there for the areolas. Her breasts were also stuck to the chest wall and had to be released and skin grafted several years ago. The nipple is a wonderful creation by God and I do not think anyone has tried to re-create God’s creation of the nipple. But you raise an interesting question, “Has anyone ever tried to make a functional nipple?” Not that I know of.
