Top Doctors Q&A: Rajiv Sood

Besides disfigurement, what problems can severe burns cause?
Once you’ve injured your skin and received a skin graft, that skin is never “normal” again. It doesn’t have the same temperature regulation, sweating, sensitivity to the environment, or barrier to infection. All that is lost. It’s going to be much more sensitive to trauma.

What are the newest developments?
One of the things burn patients get, especially younger children, is a lot of itching and inflammation. They’re often on massive doses of anti-itch medication that makes them sleepy and has other side effects. Now we use pulsed dye laser treatment to both improve the appearance of the scar and decrease inflammation. The second new technology is called the Fraxel. It basically drills holes in the burned area to different depths. We can deliver a topical drug into these holes, which seal over within two minutes or so. We’re able to deliver steroids, for example, into the depths of the scar, which we could never do before.

What’s on the horizon?
The thing I’m most excited about is something we’re working on here at IU. It’s a three-layer synthetic skin that’s basically made from the patient’s own cells. We use a bottom layer of skin that’s available commercially, then take some stem cells from the patient’s fat, which helps that bottom layer graft onto the body. Then we take a postage stamp–sized skin sample from the patient, which we break up in the operating room and can use to cover a very large area. We literally spray this new skin on, where the lower layer serves as a scaffolding for it to grow. The appearance is excellent. Hopefully in my lifetime we will be able to use this kind of technology on our patients.