Patient name: Caroleen

Mechanism of burn:                                Flame Burn

Age of initial burn injury:                        6 Months

Age presented for reconstruction:1 Year

Total body surface area involved:8%

Caroleen is a 1-year old beautiful baby girl the team met during the triage clinic on the 2009 mission to Nkhoma Hospital.  When Caroleen was just an infant her blanket accidentally caught fire when a candle tipped over where she lie sleeping on the floor of her hut.  The burns of her left leg were severe. Because the family feared they would not be able to pay for a hospitalization they attempted to treat her 3rd degree burns at home.  Although she healed, she was left with a severe disabling joint contracture of her knee which would leave her with a life-long handicap if no proper surgical reconstruction was provided.  Scar contractures occur when burns are so deep that normal skin cells cannot regenerate or possess the quality to stretch.  Delayed healing occurs without the assistance of skin graft to heal properly and the tissues essentially shrink in from the edges to heal. 

At age one, Caroleen should normally be standing and learning how to walk her first steps.  Instead, she has never learned how to crawl and her mother does her best to hide the scars with clothes and blankets, worried she may be looked at differently than other children. 

Fortunately with the help of ABR volunteer member and plastic surgeon, Dr. William Dougherty, Caroleen was provided the chance at a normal life.  During a three hour operation with ABR and Malawian team members, Caroleen’s scarred skin was able to be reassembled to release the tension of her scarred leg.  After her first surgery she was able to partially extend her leg but was still in need of therapy and serial casts to help elongate the major tendons in her leg.

Only four months after her first surgery and several cast applications, Caroleen can almost fully straighten her leg.  Her mom proudly reports she is now standing and learning how to walk.  Without this key interventional surgery Caroleen’s leg would have remained webbed, she would have never planted her foot on the ground, she would have never walked, her bone growth would have stunted, and likely would have never attended school as a disabled child in rural Malawi.

Most astounding is the little cost it took to spare her from life long impairment and embarrassment of her scar. For a price of $90 Caroleen’s specialized surgery and her hospitalization costs were covered by ABR donations, sparing the family from severe debt.

2009

Initial Presentation

Post Op

Follow Up Visit: 4 Months