Spray-On Skin

Nupur Shridhar
11 November 2007

For the past eighteen years, I have been lucky enough to have been able to take my skin for granted. My current knowledge of skin, and by extension, skin grafting - both its purpose and its procedure - has been based on the fact that, with the exception of a few mildly-troubling, acne-ridden years in middle school, my skin has not let me down: it has served well as my first line of defense against bacteria and viruses, produced sweat at an alarmingly an efficient rate both during tennis matches and college interviews, and, most entertainly, has allowed for plenty of "What can Brown do for you jokes?".

In short, because I haven't had to concern myself much with what happens when skin stops functioning as it ought to, either as a result of the natural wear and tear that results from old age or from a traumatic experience, I have a great deal to learn through the course of this academic journey.

Skin grafts are most often used on burn victims. To prevent infection and restore natural function and appearence, pieces of skin from parts of the body that aren't burned are removed, stretched to almost six times their size, and surgically grafted - transplanted - over the burned portions. Risks for skin graft surgery include bleeding, infection, and rejection of the graft which leads to loss of the grafted skin. Unfortunately, those individuals who could benefit the most from skin grafting - those that have suffered the most severe burns over a greater percentage of their bodies - are also the ones that are severely limited by their ability to produce viable skin grafts. The reason for this, as Dr. Baljit Dheansa, explains to National Geographic is that patients who have burns that extend over 50 to 60 percent of the body "don't have enough of their own skin to cover them." Fortunately, there's hope: not only will the new prodecure reduce scarring, speed up healing, and allow patients to more quickly return to a normal lifestyle, it can also, in a relatively short time - four weeks - yield enough skin cells to cover the entire surface area of the body. This is done by taking a healthy piece of epidermis the size of a postage stamp and growing it in a laboratory to produce enough cells to spray over all damaged areas.

As a potential biomedical engineering concentrator, this article inspired me to continue learning more about such procedures for two main reasons. First, the advances in skin grafting procedures reported in this article reflect the ability of biotechnology to respond to the problems presented by the limitations in previous medical practicies. Even solely in terms of cost, one single spray treatment costs $9000, substantially less than the $3680 per day for the approximately two weeks that a burn victim remains in the hospital. As Atul Gawande can attest, there is always some way to make medicine better, and, someday, instead of reading about other scientists' discoveries, I'd like to be one of the researchers making those improvements. Second, I am a firm believer in the ability, and responsibilty, of biotechnology to not only improve the medical condition of a sick patient but also their quality of life. After all, at some point, a life filled with pain, physical or mental, is arguably no longer worth living, and for those burn victims for whom spray-on skin cells would provide a more attractive lifestyle - both literally and figuratively.

Biotechnology, however, must no longer focus exclusively on the healthy. While lifestyle medications like Viagra can improve the quality of life of many a man, every dollar invested in a "better" erectile dysfunction drug is one dollar less spent on a cure for a fatal medical condtion, say, for example, a newer, more effective HIV drug. There is, after all, something fundamentally wrong about a medical system that can guarantee an AIDS patient an erection but not an increase in life expectancy. Given this tendency to invest in lifestyle drugs, as well as the American tendency to commercialize any new procedure, I am worried that it will not be too long before a cosmetic procedure is derived from this medical one. To me, any procedure that would involved using spray-on skin cells to create younger-looking skin on healthy individuals would be a gross waste of medical time and money. As long as there individuals who die from diseases for which no cure has yet been found, or worse yet, individuals who die from preventable disease as a result of a lack of proper medical care and attention, there is no money to waste on development of cosmetic procedures.

Another possible consequence involves skin graft donation. Viable skin cells could certainly be taken from a donor - even an animal donor - instead of the patient. What happens, then, if this process is commercialized? Perhaps, younger, more attractive individuals like myself would have an incentive to sell their skin cells to others for a tidy sum of money. At last, a way to pay for this Brown education. On a more serious note, David Cutler, professor of economics at Harvard University and author of the book Your Money or Your Life: Strong Medicine for America's Healthcare System, would most likely agree with me when I say that creating a pecuniary incentive to donate skin cells would be unfair to poor Americans who can't afford food and clothing, never mind living life with half their skin and one kidney. In short, I am concerned that the public will once again look for a way to derive a better lifestyle for the healthy instead of focusing on the fact that for the sick, life must first go on before it can be improved.

In the end, however, I am most interested in learning how effective spray-on skin cell treatment actually is. At the time that this article was published in September of 2005, thousands of people had been treated with spray-on skin cells. How many of them actually had better results than those provided with traditional skin graft treatments? Were there instances where the damage was too severe for sprayed-on cells to work? Were there any side-effects? This is another characteristic of biotechnology inherent in all discoveries: there will always be gaps in knowledge that are a result of a lack of research. It is not at all a result of a lack of diligence, ingenuity, or intention to do right, and it is possible to assume that with time and more studies, these gaps in knowledge will be filled. In the mean time, spray-on skin cells seem to be a new and effective method of treating burn victims and one that promises much hope and improvement in quality of life.

In short, regardless of our role in the medical system, whether we are a doctor, a patient, a student, a professor, an overworked and unappreicated TA, or a blogger, we must all applaud the efforts made to develop this new technology and support and encourage, perhaps even participate in, efforts to create even better techniques.