Out of the Box: A Layer of Skin

In their continuing search for a temporary substitute for the ruined skin of burn victims, surgeons have tried sterile gauze and various kinds of fetal and animal tissue. All have been unsatisfactory. Now an everyday packaging plastic promises to provide just what the doctors want. The material is polyvinyl plastic--close kin to the stuff that goes into synthetic sponges, commercial wrappings and floor tiles.

Prepared for medical use under the name Ivalon, an experimental version of the familiar plastic has proved every bit as effective as homografts--shortlived grafts of skin taken from another person. After successful animal experiments by Buffalo's Dr. William M. Chardack, a pair of Cincinnati plastic surgeons, Drs. Byron E. Boyer and Mary M. Martin, tried the stuff on humans. They used the plastic on two children suffering deep, extensive burns. One patient, as reported in the Journal of Trauma, was a six-year-old girl whose clothes had caught fire from a gas stove. Flames seared both the outer and inner layers of skin over 55% of her body. After initial treatment for shock, dehydration and infection, the surgeons peeled away the damaged tissue. Then they took sterilized Ivalon sliced into sheets 4 mm. thick, soaked it in an antibiotic solution and sewed it over the wounds. The covering prevented infections and loss of blood and vital body fluids. Later, in a series of operations, the surgeons removed the Ivalon, as more and more of the burned areas became ready for a graft of the patient's own skin. In the case of a five-year-old boy with deep burns that covered the entire lower half of his body, the surgeons simply wrapped Ivalon around each of the boy's legs and fastened it to the charred flesh with safety pins.

For both patients, report the surgeons, the plastic covering almost surely made the difference between life and death. There was less fever and infection than with the usual homograft, and a more comfortable recovery. The plastic material lasted twice as long, and doctors were able to remove it with fewer complications.

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