A Life-Saving Discovery at MIT MechE

Updated : Dec 31, 2019 in Articles

A Life-Saving Discovery at MIT MechE

[MUSIC PLAYING] Please welcome MIT professor
and 2015 National Inventors Hall of Fame Inductee,
Ioannis Yannas. This discovery changed
my professional life. The discovery we made, Dr. John
Burke– my surgeon colleague and myself. It was a big surprise,
totally unexpected, and hard to believe. It used to be called
artificial skin, but it was soon recognized
as the first example of organ regeneration in adults. Being inducted to the National
Inventors Hall of Fame is a very big honor for
me, especially when I look at the names
of other people who had been previously
deducted– names like Steve Jobs and Wozniak, Louis
Pasteur, the Wright Brothers– important names
that I grew up with. It really makes me
feel a little small. My photo was shown like I was
the leader of a totalitarian regime. A little too much for me. What I see is what used
to be many, many years ago when this discovery was made. Some of our nation’s
greatest living inventors. The recognition that
this work is getting will make it more clear
there is something here that has future and needs to
be developed by other people and made into one of the
brand new tools of medicine. In 1969, I was an
assistant professor at MIT. I thought that it
could be a great idea to meet one of the doctors
in the Boston area. That person turned
out to be Dr. John Burke who was then head
of the Shriners Burns Institute in Boston. I found in him in a very
difficult problem in medicine that I thought I could
contribute to each solution. And I think what he saw in me
was a material scientist who could create a
material that would be useful to treat his patients. There was a mutual clicking
that happened when we met. Dr. Burke was looking for a
very sophisticated Band-Aid. He had patients who
were mostly children. The children had massive burns. Basically, the prelude to
death unless you do something drastic about it. Dr. Shelton, Dr. Paul Shelton. I remember very clearly the
day that Dr. Burke took me on a tour of one of the wards. It was a very, very
difficult sight. I was shocked. I was shocked beyond belief
in what I was seeing there. It was a very important
moment in my life, because it guided me
towards a direction that I would not have chosen. I remember the children
were lying in their beds. There was extensive bandaging of
faces and limbs in these kids. Yeah. Dr. Burke would softly
explain the situation to me. These pictures, in my
mind, have stayed with me. And they became the
reason why I started working on this project. There was a great deal of human
misery that was confronting me. And I felt that I had to
do something about it. It was clear that we
needed to solve the problem as soon as possible. The objective of speeding up the
rate of closing of these wounds that, in effect,
became the problem that Dr. Burke and I
would have to solve. My students and myself
were synthesizing polymers from different
chemical families– things like plastics,
rubbers, textile fibers, and the tissues of our body. We were putting things
dressings in foils. We would then take
the subway to Boston and then go to the Shriners
animal laboratory facility. The technician would then
put them on the animals. This was going on family
after chemical family. None of the dressings
we had worked with had any effect on
the speed of closure of these wounds in the animals. So far the projects had
been a total failure. I started thinking that maybe
a polymer I had been working with in my PhD thesis, which
was collagen– a collagen is a polymer of the
tissues of the body– that maybe I should try this
since almost everything else had failed. Lo and behold, this
collagen dressing, instead of speeding up
the rates of closure, it actually delayed it and
make it very, very slow so that’s the wound
would hardly close. We were basically
going the wrong way. Instead of making
it close faster, we’re making it close slower. Nobody likes to have
a failed experiment. It’s the last thing you want. Trying to get to understand
why the experiment had failed was a very important step. This was a great moment for
myself and for Dr. Burke. It was a great moment
because of what we decided to do with
that failure, which was to not just let go
and go home and cry, but to start trying to
understand what had happened. It was then that we saw
that the animals that had been treated
with the collagen dressings we’re not making scar
as every other animal before had done. The last dressing we had used
was actually causing new skin to be formed instead of
scar– skin not scar– skin that functions like skin as
opposed to scar that does not function like skin. In addition to keeping
children alive, it gave them a chance to regrow
the skin that they had lost. It was way beyond
what I expected. It was way, way beyond that. We could hardly find it
possible to publish our results, because people would not want to
publish a paper that says that you have regenerated something
that everybody knows you cannot regenerate. Dr. Burke was very happy,
because he could see now a new way of treating
his patients that did not exist before. Back in the 1970s, there were
a lot of advances in ICU care. And as a result of that, these
very severe burn patients were able to be kept alive
for long periods of time, but they oftentimes didn’t
have enough donor sites or skin to cover them up. So it was a bleak time. Dr. Burke was a surgeon
who espoused the concept of early excision and grafting. That wasn’t universally
adopted back then. Taking a patient to
the operating room early on to carry out
excision and grafting was a dangerous prospect
for the patient. The excision can easily lead
to very significant blood loss. In addition,
harvesting donor sites can lead to
significant blood loss. So you needed a surgeon like
Dr. Burke who was meticulous, who was careful, and did
this relatively new technique and to make this
invention successful. The availability of Dr. Burke
and Yannas’s artificial skin, which became known as
INTEGRA, tipped the scale towards early excision and
grafting of large body surface area burns. Our skin is made up of two
layers, the outer epidermis and the inner dermis. Now the epidermis is damaged. It grows back quickly,
and it regenerates. But when our dermis
is damaged, the dermis never grows back by itself. Instead the wound contracts
and forms the scar. Now when our
regeneration template, or what used to be called
artificial skin, when that is used, something
entirely different things. The contraction is stopped. And the cells of the person
move into the template. There, the cells regenerate
a new dermis or the template is broken down and absorbed. Not only are you able to
solve the acute burn problem and keep the patients
alive, but at the end, you’re able to give
them the skin that’s more natural and supple,
pliable with less scar. Back before advances like
INTEGRA were available, patients like Lauren, who
had 35% full thickness burn injuries were
at risk of dying. And now our goal is
to try to restore them as much as possible to the
state that they were in prior to having the injury. So that is an absolutely
transformative change in burn care over the
course of my lifetime. And what Dr. Burke
and Dr. Yannas did has played a huge role in
that change in our goals. Look so good. You’ve made my day. [PATIENT LAUGHING] It is quite clear
that many lives were saved by the development
of the artificial skin. We have a patient at
Shriners right now who sustained an over 80% deep
second and third degree burn. And his life was clearly
saved by the use of INTEGRA. My name is Matthew Hicks. Are you going to get shy? Yeah. Yeah? No. No. This is my son Mason. He’s eight years old. He was burned on
87% of his body. And uh, yeah. Mason has the most
incredible personality. He’s very easy to
fall in love with. Let me know. [MASON CHUCKLES] He’s no longer stuck
in a wheelchair. He just learned to
walk a year ago again. And he’s out playing soccer. He’s playing with the
kids in the neighborhood. And he’s just like
a regular kid again. He was burned on
87% of his body, in and out of surgery
every other day for a good two or three weeks. They were using a lot
of different things to cover his skin
including INTEGRA. We’re in the reconstructive part
of the surgeries at this point. Nothing holds him back. Nothing at all. INTEGRA definitely
had an integral part in saving his life. There was no way he had
enough of his own skin to cover his body. Without it, God, I have
no idea where we’d be. I don’t think he’d
still be here. [MUSIC PLAYING] To younger faculty,
I would say, go where the ignorance is maximum,
because that’s where you’re going to discover the goal. What is meant by this is
that many young researchers go where everybody
else is doing research. And basically, they add an
incremental piece of value to what has happened before. I would go where
there already is no value established by
others, because no one has thread that ground. I was born in Athens, Greece. I had somewhat of an early
introduction to science. When I was six or
seven-year-old, I got a hold of a little
bottle of tincture of iodine. And putting it over a gas flame
in the kitchen of my home, the alcohol evaporated. And there I was
holding the test tube with a couple of little
beautiful light purple crystals of iodine. It was actually one of the most
beautiful things I’ve had seen. I would never forget that. Ladies and gentlemen, please
welcome the 2015 National Inventors Hall of Fame– When Dr. Burke and I got
together and started working, there was a step that
very few people today in science or
medicine undertake. It’s a step requires
working across disciplines, which means working in
areas that you’re not comfortable with. Like I was not comfortable
in Dr. Burke’s surgeries. And he was not comfortable
with my molecules. The fact that we
got together was something that was
very difficult. And I would credit this with the
success that we eventually got. There are two sources
of satisfaction that A person my position has. One is the opportunity to see
people treated with something that he has helped discover. [MUSIC PLAYING] And that’s a very big, big deal. [MUSIC PLAYING] The other is that if
you’re a scientist, and you see what’s going on on
the other side of the mountain that nobody else has, that’s
a very, very strange feeling. It’s like looking at a
vista that is brand new and has never been seen. And I like that as well. [MUSIC PLAYING]


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