Trial by teapot in the burns unit

Caroline Dilke describes how she hobbled towards a skin graft after waking up to find she had scalded herself with tea
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Indy Lifestyle Online
"Very common complaint among the elderly," the consultant surgeon said. "They throw hot drinks over themselves, or their carers do it for them." I began to protest - I'm not elderly - then shut up. Being taken into hospital is like being kidnapped by an extreme religious sect: it's wisest to be polite to your captors.

The accident could have happened to anyone. I had had flu and a fever, and had made a pot of tea. Finding myself on the floor with the teapot, I realised I must have blacked out: the tea was tepid. I picked a teabag off my wet clothes and changed into dry pyjamas. Yes, it hurt, and next morning I was deep purple from thigh to waist, and hung with blisters the size of lemons.

"So you can't feel anything at all?" asked the nurse, prodding the burnt area with a needle. Sorry, as it turned out, but no. They told me that in some places the skin had been burnt down to the fat layer and the nerves had been destroyed.

I was in the acute burns unit of Queen Mary's University Hospital, Roehampton - soon to be the site for the UK's Skin Bank, where skin from cadavers will be used as "next best" treatment for patients too severely burnt to be grafted with their own skin.

In the next room lay what looked like a bandaged mummy on a respirator. The sound of his life-support machine was so insistent it took me two days to learn to breathe out of sync. Now and again a helicopter clattered overhead, bringing in a new patient. When friends and relatives visited, they had to wear paper gowns and special shoes. My mother refused to be intimidated. "There's something noble about trial by fire," she pointed out, "but trial by tea is ... tacky."

For a week I was anointed with a magic cream and subjected to daily baths; in between I hobbled about in bandages. They were hoping some of the burn would heal without a graft.

"What got you? Hot-water bottle?"

"No. Teapot." I was now in sub-acute, exchanging stories with other female victims. The men in the ward next door were younger; here the theme was cigarette ends and petrol. There was also a room full of toddlers who had fallen foul of the chip pan.

As the scar shrank I limped even more grotesquely. This could be it, I realised: I had aged 30 years and become a cripple. Instead, they decided to graft. With an extremely sharp gadget resembling a cheese grater, wide strips of skin are neatly removed and passed through a "meshing" machine, which punches hundreds of holes. These are tiny enough, even when the skin is stretched, for the body to fill them in with new skin. The burnt skin is shaved right off - the patient loses a lot of blood - and the graft is laid on and secured with stitches or staples. They refrigerate some extra skin in case repairs are needed. I was assured that after about a year, the donor sites would show no signs of their traumatic flaying.

The day of the operation I joined two anaesthetists in a lively conversation about Asian wedding customs while I went under. An hour and a half later I woke up on a morphine drip. This was self-administered: I could press a button when I needed another dose (they obviously trusted me not to become a junkie). I was put on a high-protein diet to help my body make new skin. The dressings stayed for five days, smelling ever more insistently of rotting meat. Then they were removed: the graft had taken.

It was hard to accept, but a fairly large area between waist and knees was no longer my own: it wore a robot's imitation of skin, red and spongy and unnaturally shiny. I did not dare ask whether this would ever look normal. Later, an out-patient was kind enough to show me a similar repair, now two years old. I was impressed. "No, you can just see it. It's paler," she said.

The nurses revealed a little at a time. Burns are "dirty" wounds, open to infection, so that was the first great fear. Later, when the pain of the donor sites had faded, I was asked, "Is it itchy?" Itchiness is normal, caused by electric shocks that shoot across the deep parts of a burn when nerves are regrowing as they should. The blisters on the grafted areas were normal, too.

Finally I was discharged, to walk stiffly about and almost bent double, on legs that excited embarrassing interest from dogs, with voluminous bandages that occasionally fell off into the road. I longed to be able to walk upright, but the robot skin just was not flexible enough. It took weeks before the wounds healed, and even now, three months after the accident, I am unable to spring up from a sitting position and immediately stand straight.

Recently, the hospital broke the news that for at least a year I would have to wear a "garment" to avoid scarring. "It'll be specially made, just for you." It turned out to be a pair of flesh-coloured elastic shorts, tight but comfortable. Apparently, many patients become so attached to these that they go on wearing them for years after they need to. I am not sure yet whether I will, though.

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