Our health system flies!

The 2005 Australian of the Year Fiona Wood gave an inspirational speech to the NSWNMA Professional Conference about her work with burns injuries.

She went to a Quaker village school because the state system said she wasn’t university material. At medical school in London she fell in love with plastic surgery and still is. “I could talk about skin all day.”

Next Fiona Wood fell in love with an Australian surgeon, arrived in Australia in 1987 with him and their two children under two*. Her first application for a plastic surgery registrar’s job in Australia failed because “no mother with two children could possibly do that job.

“That was a bit tricky,” Fiona told the NSWNMA 2013 Professional Day.

But her mum didn’t pick Brussels sprouts in the fog of northern winters to educate a girl who’d be stopped at such hurdles. From her first day at a village Quaker school she heeded her mother’s advice “grasp the nettle with both hands Fiona, never let it go.”

In 1990 as a plastic surgery registrar at the Sir Charles Gairdner Hospital in Perth, she watched with a sense of “powerlessness and exasperation” a 56-year-old woman with 70 per cent body surface burns. Then she heard on her car radio a report of a Monash scientist growing skin.

“It was like a lightning bolt. It was a time I know I refused to hear ‘no.’ We sent the last little piece of her donor site that was healed to Monash, They grew the skin cell sheets and we brought them back three weeks later.

Three weeks later and five months post-burn the woman was out of intensive care and on the burns unit. At seven months post burn she died.

“The temptation to dive in a hole and forget about it was enormous. All those people I had coerced and cajoled into helping and it didn’t work. Or I could stand back and think how can that life save another?

“Twenty three years down the track there have been many lives saved because of the experiences of that time.

“I’d seen the power of taking some skin from an individual, putting it into a lab and allowing it to grow and bringing it back so it covered the whole person. “

In January 1991, Fiona was appointed director of the Burn Service of Western Australia. “I inherited a great team and one of the biggest groups in our team is the nurses. I may spend a lot of hours in the operating room but nurses spend weeks keeping the skin grafts on day in, day out. It’s that teamwork that is making a difference, the allied health, the nursing, the surgery, and infection control. In building that team it was clear to me in order to go forward we had to take our blinkers off, work across the board with other people and work out how we could deal with this problem of burn injury in a different and innovative way.”

In 1993 Fiona and scientist Marie Stoner were granted funding to treat 12 patients, sending skin to Melbourne to grow and getting it back to the patient. It was a 21-day process.

Another grant established a lab to grow skin in WA. Stoner grew the cells in 10 days. In 1994 they decided, “we should spray this stuff on.”

Marie and Fiona clipped the nozzle of a commonly available mouth freshener spray onto a 5ml syringe and their result was “spray on skin”. Though in fact it’s sprayed on at the dermal epidermal junction. By 1995 tissue growth time had been reduced to 30 minutes using a technique that puts the tissue engineering process in a box in the operating room.

The tissue is programmed to make skin not scar so when the wound is well prepared there is a regenerative pattern not a scar pattern.

In 2005 Fiona was named Australian of the Year following her work with the burns team at Royal Perth Hospital who fought to save 28 Bali bombing victims suffering between 2 and 92 per cent body burns, infections and delayed shock.

“Thirty years ago I had this feeling the whole focus of scarless healing would be a bit like climbing the mountain and putting the flag on the top and then we’d all go down to the beach and drink piña colada,” Fiona said.

“I’ve learned that’s not the way; it’s all about the journey and there’s no such thing as a bad decision; you learn from it, live with it and make sure the next one’s better.

“So when I look at doing basic science and the health system I say ‘yay.’ We look at the NHS, we look at the American system and we say what is it about the Australian system that flies? We live in an environment that is extraordinarily privileged. Let’s not let it slip through our fingers like sand.”

*Fiona now has six children. In the early nineties she sometimes took her eldest to work with her in the lab. His Grade One drawing project was a skin incubator. “He’s a bit of a nerd.”