[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:13.47,0:00:15.61,Default,,0000,0000,0000,,Thank you, that's right.\NI'm Fiona Wood.
Dialogue: 0,0:00:15.61,0:00:18.08,Default,,0000,0000,0000,,I'm a plastic and reconstructive \Nsurgeon,
Dialogue: 0,0:00:18.08,0:00:19.84,Default,,0000,0000,0000,,and for the last 30 years --
Dialogue: 0,0:00:19.84,0:00:23.80,Default,,0000,0000,0000,,I've spent my whole \Nprofessional life focused on
Dialogue: 0,0:00:23.80,0:00:27.66,Default,,0000,0000,0000,,and trying to treat people \Nwith burn injuries.
Dialogue: 0,0:00:27.66,0:00:31.72,Default,,0000,0000,0000,,I think as a plastic surgeon \NI see suffering on a daily basis.
Dialogue: 0,0:00:31.72,0:00:35.02,Default,,0000,0000,0000,,I see people's lives \Nthat have changed in an instant.
Dialogue: 0,0:00:35.02,0:00:39.48,Default,,0000,0000,0000,,When I look back and sort of introspect, \NI guess, over those 30 years,
Dialogue: 0,0:00:39.48,0:00:45.48,Default,,0000,0000,0000,,where did I start ? Where did I start \Nto think that we could do better ?
Dialogue: 0,0:00:45.48,0:00:48.72,Default,,0000,0000,0000,,And I've traced that back \Nto seeing a young child,
Dialogue: 0,0:00:48.72,0:00:51.71,Default,,0000,0000,0000,,a young child in 1985.
Dialogue: 0,0:00:51.71,0:00:55.32,Default,,0000,0000,0000,,A cup of coffee had gone down \Nthe front of that chest.
Dialogue: 0,0:00:55.32,0:00:58.90,Default,,0000,0000,0000,,There had been a period \Nof time for painful dressings,
Dialogue: 0,0:00:58.90,0:01:04.24,Default,,0000,0000,0000,,the cries that would probably \Nnever leave the mother and father.
Dialogue: 0,0:01:04.24,0:01:07.26,Default,,0000,0000,0000,,All those weeks for healing,
Dialogue: 0,0:01:07.26,0:01:09.72,Default,,0000,0000,0000,,and I was working \Nin a plastic surgery center
Dialogue: 0,0:01:09.72,0:01:12.30,Default,,0000,0000,0000,,in the South of England \Nat that time
Dialogue: 0,0:01:12.30,0:01:15.89,Default,,0000,0000,0000,,and this child turned up \Nat our plastic surgery center.
Dialogue: 0,0:01:15.89,0:01:21.12,Default,,0000,0000,0000,,"The burns are healed now, \Nhe needs plastic surgery."
Dialogue: 0,0:01:21.12,0:01:23.87,Default,,0000,0000,0000,,It hit me straight between the eyes,
Dialogue: 0,0:01:23.87,0:01:27.08,Default,,0000,0000,0000,,that this boy would never move \Nproperly again,
Dialogue: 0,0:01:27.08,0:01:29.72,Default,,0000,0000,0000,,he would never move \Nhis neck or his arm,
Dialogue: 0,0:01:29.72,0:01:34.08,Default,,0000,0000,0000,,that the scars that had been left \Nfrom a very simple situation\N
Dialogue: 0,0:01:34.08,0:01:36.96,Default,,0000,0000,0000,,would be with him for life.
Dialogue: 0,0:01:36.96,0:01:41.40,Default,,0000,0000,0000,,And so as I moved forward through \Nmy education and my training as a surgeon,
Dialogue: 0,0:01:41.40,0:01:46.51,Default,,0000,0000,0000,,I became increasingly focused \Non how to make sure
Dialogue: 0,0:01:46.51,0:01:51.02,Default,,0000,0000,0000,,that the quality of the outcome \Nwas worth the pain of survival.
Dialogue: 0,0:01:51.02,0:01:53.99,Default,,0000,0000,0000,,Many of you may have burnt \Nyourselves on the arm,
Dialogue: 0,0:01:53.99,0:01:56.79,Default,,0000,0000,0000,,just done a bit of a splash of oil \Nwhen it's cooking.
Dialogue: 0,0:01:56.79,0:02:00.91,Default,,0000,0000,0000,,Just bear one second, \Na fraction of a second,
Dialogue: 0,0:02:00.91,0:02:04.19,Default,,0000,0000,0000,,for half your body being burnt.
Dialogue: 0,0:02:04.19,0:02:06.28,Default,,0000,0000,0000,,Ten years ago, \Nthis month,
Dialogue: 0,0:02:06.28,0:02:11.46,Default,,0000,0000,0000,,was a tragedy that touched \Nmany people across the world
Dialogue: 0,0:02:11.46,0:02:13.47,Default,,0000,0000,0000,,but in particular touched Australia,
Dialogue: 0,0:02:13.47,0:02:15.41,Default,,0000,0000,0000,,it was the Bali bombings.
Dialogue: 0,0:02:15.41,0:02:18.34,Default,,0000,0000,0000,,It was at the ten year review,
Dialogue: 0,0:02:18.34,0:02:21.45,Default,,0000,0000,0000,,when I was talking to \None of these young men,
Dialogue: 0,0:02:21.45,0:02:24.46,Default,,0000,0000,0000,,the captain of the football team,
Dialogue: 0,0:02:24.46,0:02:26.83,Default,,0000,0000,0000,,who found himself in \Nthat nightclub that night,
Dialogue: 0,0:02:26.83,0:02:30.03,Default,,0000,0000,0000,,and he described\Nhow he fell into the flames,
Dialogue: 0,0:02:30.03,0:02:31.81,Default,,0000,0000,0000,,he broke his back, \Nhe lost all his teeth, \N
Dialogue: 0,0:02:31.81,0:02:36.13,Default,,0000,0000,0000,,he had multiple fractures,\Nand 70% of his body was burnt.
Dialogue: 0,0:02:36.13,0:02:38.41,Default,,0000,0000,0000,,He went on to survive
Dialogue: 0,0:02:38.41,0:02:42.13,Default,,0000,0000,0000,,and he described on this occasion \Ntwo weeks ago,
Dialogue: 0,0:02:42.13,0:02:44.96,Default,,0000,0000,0000,,the pain of that injury.
Dialogue: 0,0:02:44.96,0:02:49.72,Default,,0000,0000,0000,,But he also went on to describe \Nthe pain of the healing,
Dialogue: 0,0:02:49.72,0:02:51.22,Default,,0000,0000,0000,,week in, week out,
Dialogue: 0,0:02:51.22,0:02:53.06,Default,,0000,0000,0000,,and the recovery, \Nthe rehabilitation
Dialogue: 0,0:02:53.06,0:02:55.83,Default,,0000,0000,0000,,and making sure \Nthat when he first left,
Dialogue: 0,0:02:55.83,0:02:58.15,Default,,0000,0000,0000,,and he couldn't clean his teeth \Nor brush his hair,
Dialogue: 0,0:02:58.15,0:03:01.10,Default,,0000,0000,0000,,how he drove over \Nthat first 3-4 years,
Dialogue: 0,0:03:01.10,0:03:04.62,Default,,0000,0000,0000,,to the point where he had \Na full range of movement.
Dialogue: 0,0:03:04.62,0:03:06.99,Default,,0000,0000,0000,,The scars will never leave him.
Dialogue: 0,0:03:06.99,0:03:09.93,Default,,0000,0000,0000,,So, as a surgeon, when I say \NI've come to talk to you today about
Dialogue: 0,0:03:09.93,0:03:12.43,Default,,0000,0000,0000,,"How can we do it better?"
Dialogue: 0,0:03:12.43,0:03:16.74,Default,,0000,0000,0000,,You know that it is what we live, \Nwhat we breathe, on a daily basis.
Dialogue: 0,0:03:16.74,0:03:21.48,Default,,0000,0000,0000,,We see sufferings, we see lives changed \Nin an instant, and it can happen to anyone.
Dialogue: 0,0:03:21.48,0:03:23.88,Default,,0000,0000,0000,,So, what do we do?
Dialogue: 0,0:03:23.88,0:03:26.06,Default,,0000,0000,0000,,When someone has \Na burnwound, the skin --
Dialogue: 0,0:03:26.06,0:03:28.37,Default,,0000,0000,0000,,I could talk about skin forever,
Dialogue: 0,0:03:28.37,0:03:32.19,Default,,0000,0000,0000,,it's a fascinating organ, \Nthat's well and truly underrated.
Dialogue: 0,0:03:32.19,0:03:35.34,Default,,0000,0000,0000,,Now, what a beautiful thing is skin.
Dialogue: 0,0:03:35.34,0:03:40.31,Default,,0000,0000,0000,,It helps to keep your body in, \Nhow amazing. (Laughter)
Dialogue: 0,0:03:40.31,0:03:43.34,Default,,0000,0000,0000,,It does all sorts of things, \Nit's your interface to the world.
Dialogue: 0,0:03:43.34,0:03:46.13,Default,,0000,0000,0000,,We look at a baby \Nand we smell that baby,
Dialogue: 0,0:03:46.13,0:03:50.59,Default,,0000,0000,0000,,and we smell that skin,\Nand how exquisite it is.
Dialogue: 0,0:03:50.59,0:03:54.16,Default,,0000,0000,0000,,How could we get back to \Nthat when it's damaged ?
Dialogue: 0,0:03:54.16,0:03:55.46,Default,,0000,0000,0000,,Only it takes very little,
Dialogue: 0,0:03:55.46,0:03:57.25,Default,,0000,0000,0000,,our skin is turning over \Nall the time,
Dialogue: 0,0:03:57.25,0:04:01.37,Default,,0000,0000,0000,,it takes very little \Nto overwhelm that capacity,
Dialogue: 0,0:04:01.37,0:04:03.71,Default,,0000,0000,0000,,so it can't repair itself.
Dialogue: 0,0:04:03.71,0:04:05.50,Default,,0000,0000,0000,,It can't return to the functions
Dialogue: 0,0:04:05.50,0:04:10.42,Default,,0000,0000,0000,,of temperature control,\Nbacterial control, etcetera.
Dialogue: 0,0:04:10.42,0:04:14.69,Default,,0000,0000,0000,,So many functions I couldn't even begin\Nin 18 minutes to talk about.
Dialogue: 0,0:04:14.69,0:04:17.45,Default,,0000,0000,0000,,So, what do we do then?
Dialogue: 0,0:04:17.45,0:04:19.21,Default,,0000,0000,0000,,Look around \Nand take your blinkers off.
Dialogue: 0,0:04:19.21,0:04:23.22,Default,,0000,0000,0000,,I think anybody in science these days \Nhas got to seriously have their blinkers off.
Dialogue: 0,0:04:23.22,0:04:26.58,Default,,0000,0000,0000,,They've got to look and see where else\Nthey can find information.
Dialogue: 0,0:04:26.58,0:04:29.21,Default,,0000,0000,0000,,And certainly in embryology \Nand in biological sciences,
Dialogue: 0,0:04:29.21,0:04:32.73,Default,,0000,0000,0000,,in genetics we can see \Nall sorts of things happening.
Dialogue: 0,0:04:32.73,0:04:35.28,Default,,0000,0000,0000,,I can see a gecko can grow a tail,
Dialogue: 0,0:04:35.28,0:04:39.44,Default,,0000,0000,0000,,yet I can't repair \Na wound without scarring.
Dialogue: 0,0:04:39.44,0:04:41.96,Default,,0000,0000,0000,,Now we may step back \Nfrom this and think,
Dialogue: 0,0:04:41.96,0:04:43.54,Default,,0000,0000,0000,,"Wow, what is it that we do? "
Dialogue: 0,0:04:43.54,0:04:47.09,Default,,0000,0000,0000,,So, I'd like to take you \Nto the last 20 years
Dialogue: 0,0:04:47.09,0:04:49.92,Default,,0000,0000,0000,,of work in the area \Nof skin grafting.
Dialogue: 0,0:04:49.92,0:04:54.25,Default,,0000,0000,0000,,When you treat somebody with burns\Nit's a massive juggling exercise.
Dialogue: 0,0:04:54.25,0:04:58.12,Default,,0000,0000,0000,,We have the pain, we still have infection \Nas the biggest killer,\N
Dialogue: 0,0:04:58.12,0:05:02.06,Default,,0000,0000,0000,,we have to seal the skin over as the waves \Nof infection relentlessly come
Dialogue: 0,0:05:02.06,0:05:04.77,Default,,0000,0000,0000,,and weaken that body, \Nweaken it,
Dialogue: 0,0:05:04.77,0:05:08.22,Default,,0000,0000,0000,,weaken the ability \Nof the bone marrow to respond.
Dialogue: 0,0:05:08.22,0:05:09.59,Default,,0000,0000,0000,,And we try to seal that surface,
Dialogue: 0,0:05:09.59,0:05:12.88,Default,,0000,0000,0000,,so once we got that surface sealed, \Nwe're safe.
Dialogue: 0,0:05:12.88,0:05:17.58,Default,,0000,0000,0000,,And then the healing goes on, \Nas I've described.
Dialogue: 0,0:05:17.58,0:05:21.23,Default,,0000,0000,0000,,But it gives us an opportunity for life,\Nif we can seal that surface,
Dialogue: 0,0:05:21.23,0:05:25.81,Default,,0000,0000,0000,,we are safe and we can have \Nthat opportunity to live again,
Dialogue: 0,0:05:25.81,0:05:28.47,Default,,0000,0000,0000,,to then rebuild \Nthe skin underneath.
Dialogue: 0,0:05:28.47,0:05:30.18,Default,,0000,0000,0000,,So how do we create that surface,
Dialogue: 0,0:05:30.18,0:05:33.62,Default,,0000,0000,0000,,if 50% of your body surface is gone,
Dialogue: 0,0:05:33.62,0:05:35.92,Default,,0000,0000,0000,,there's only 50% to get skin from.
Dialogue: 0,0:05:35.92,0:05:37.92,Default,,0000,0000,0000,,And so traditionally, \Nmany years ago --
Dialogue: 0,0:05:37.92,0:05:41.85,Default,,0000,0000,0000,,the first skin graft done \Nwas in the 1800's,
Dialogue: 0,0:05:41.85,0:05:44.21,Default,,0000,0000,0000,,that's a serious little time ago.
Dialogue: 0,0:05:44.21,0:05:46.98,Default,,0000,0000,0000,,And so traditionally, when I started, \Nover 30 years ago,
Dialogue: 0,0:05:46.98,0:05:51.30,Default,,0000,0000,0000,,we would take the surface of the skin,\Njust skim that surface
Dialogue: 0,0:05:51.30,0:05:54.67,Default,,0000,0000,0000,,with a very large tool, \Nvery sharp knife,
Dialogue: 0,0:05:54.67,0:05:59.58,Default,,0000,0000,0000,,and still skim that surface, \Nso we'd got a split thickness skin graft.
Dialogue: 0,0:05:59.58,0:06:02.39,Default,,0000,0000,0000,,We can change that \Nsplit thickness skin graft
Dialogue: 0,0:06:02.39,0:06:05.04,Default,,0000,0000,0000,,to mesh it and make it larger.
Dialogue: 0,0:06:05.04,0:06:10.38,Default,,0000,0000,0000,,So if I take a piece from a leg, \NI can cover maybe 2/3 of an arm.
Dialogue: 0,0:06:10.38,0:06:12.91,Default,,0000,0000,0000,,Maybe just less.\NBy meshing it out.
Dialogue: 0,0:06:12.91,0:06:17.01,Default,,0000,0000,0000,,But that scar then look like a mesh.
Dialogue: 0,0:06:17.01,0:06:19.72,Default,,0000,0000,0000,,So how, when we get bigger \Nand bigger burns,
Dialogue: 0,0:06:19.72,0:06:22.48,Default,,0000,0000,0000,,we're in a situation \Nwhere technologies are advancing,
Dialogue: 0,0:06:22.48,0:06:25.08,Default,,0000,0000,0000,,we know the people \Ncan survive major burns.
Dialogue: 0,0:06:25.08,0:06:28.72,Default,,0000,0000,0000,,And I recently had coffee \Nwith a patient I met in 1991,
Dialogue: 0,0:06:28.72,0:06:30.91,Default,,0000,0000,0000,,1st of October in 1991,
Dialogue: 0,0:06:30.91,0:06:34.80,Default,,0000,0000,0000,,as I'd not long been director \Nof the Burns Service in Western Australia.
Dialogue: 0,0:06:34.80,0:06:37.75,Default,,0000,0000,0000,,He had 92% body surface area burns,
Dialogue: 0,0:06:37.75,0:06:40.42,Default,,0000,0000,0000,,and I was expected to walk away.
Dialogue: 0,0:06:40.42,0:06:43.41,Default,,0000,0000,0000,,And I said, "We don't walk away,\Nbecause we have now the technology
Dialogue: 0,0:06:43.41,0:06:46.91,Default,,0000,0000,0000,,\Nto move forward \Nto ensure his survival."
Dialogue: 0,0:06:46.91,0:06:50.50,Default,,0000,0000,0000,,And 20 years later \NI was having coffee with him.
Dialogue: 0,0:06:50.50,0:06:53.06,Default,,0000,0000,0000,,So, how did we achieve that?
Dialogue: 0,0:06:53.06,0:06:55.84,Default,,0000,0000,0000,,When he only had 8% \Nof his body left?
Dialogue: 0,0:06:55.84,0:06:58.17,Default,,0000,0000,0000,,Where could we get \Nthe skin from?
Dialogue: 0,0:06:58.17,0:07:00.58,Default,,0000,0000,0000,,Well, clearly we can't.
Dialogue: 0,0:07:00.58,0:07:04.19,Default,,0000,0000,0000,,So many years ago,\Nin that famous institution
Dialogue: 0,0:07:04.19,0:07:09.19,Default,,0000,0000,0000,,in Boston, the MIT, \Nthey started growing skin cells
Dialogue: 0,0:07:09.19,0:07:11.97,Default,,0000,0000,0000,,because we're into sheets, \Nwe're into skin grafts,
Dialogue: 0,0:07:11.97,0:07:15.81,Default,,0000,0000,0000,,we understand how the blood vessels \Ncan come into that sheet
Dialogue: 0,0:07:15.81,0:07:18.50,Default,,0000,0000,0000,,and establishes connections \Nwith the surface. \N
Dialogue: 0,0:07:18.50,0:07:20.72,Default,,0000,0000,0000,,We can change the skin from here to here,
Dialogue: 0,0:07:20.72,0:07:26.20,Default,,0000,0000,0000,,we understand that. \NSo we grew skin cells into sheets.
Dialogue: 0,0:07:26.20,0:07:28.80,Default,,0000,0000,0000,,By this time, these skins cells \Nwere 10 cells thick,
Dialogue: 0,0:07:28.80,0:07:31.11,Default,,0000,0000,0000,,we knew which way was up \Nand which way was down,
Dialogue: 0,0:07:31.11,0:07:35.05,Default,,0000,0000,0000,,10 cells thick, you can imagine,\Nthat's quite challenging.
Dialogue: 0,0:07:35.05,0:07:39.26,Default,,0000,0000,0000,,But certainly, back in 1992,\Nat that stage,
Dialogue: 0,0:07:39.26,0:07:43.46,Default,,0000,0000,0000,,there were one place in Australia\Nthat was growing skin,
Dialogue: 0,0:07:43.46,0:07:46.27,Default,,0000,0000,0000,,there was one other place in the world \Nthat was growing skin commercially,
Dialogue: 0,0:07:46.27,0:07:47.84,Default,,0000,0000,0000,,and that was Boston.
Dialogue: 0,0:07:47.84,0:07:53.74,Default,,0000,0000,0000,,And so we could send a piece of skin from \N-- I live in Western Australia.
Dialogue: 0,0:07:53.74,0:07:57.17,Default,,0000,0000,0000,,We sent that skin \Novernight to Melbourne
Dialogue: 0,0:07:57.17,0:07:59.42,Default,,0000,0000,0000,,they grew it into sheets \Nthat came back.
Dialogue: 0,0:07:59.42,0:08:03.79,Default,,0000,0000,0000,,We put these sheets on \Nand we'd got an element of cure,
Dialogue: 0,0:08:03.79,0:08:05.29,Default,,0000,0000,0000,,we'd got an element of closure,
Dialogue: 0,0:08:05.29,0:08:08.09,Default,,0000,0000,0000,,we were able to save a life.
Dialogue: 0,0:08:08.09,0:08:12.88,Default,,0000,0000,0000,,But that skin was over \Nin that laboratory for three weeks.
Dialogue: 0,0:08:12.88,0:08:16.41,Default,,0000,0000,0000,,Every day in a burns unit \Nis a day too long.
Dialogue: 0,0:08:16.41,0:08:20.35,Default,,0000,0000,0000,,How could we stop that? \NHow could we shorten that three weeks?
Dialogue: 0,0:08:20.35,0:08:22.07,Default,,0000,0000,0000,,That's where my story started,
Dialogue: 0,0:08:22.07,0:08:25.18,Default,,0000,0000,0000,,engaging the whole concept \Nof tissue engineering,
Dialogue: 0,0:08:25.18,0:08:26.71,Default,,0000,0000,0000,,tissue expansion.
Dialogue: 0,0:08:26.71,0:08:30.28,Default,,0000,0000,0000,,Myself and Marie Stone, \Nthe scientist I worked with,
Dialogue: 0,0:08:30.28,0:08:34.47,Default,,0000,0000,0000,,we raised money, \Nwe started our own laboratory.
Dialogue: 0,0:08:34.47,0:08:37.99,Default,,0000,0000,0000,,If you heal a burn within 10 days, \Nyou get a 4% risk of scarring,
Dialogue: 0,0:08:37.99,0:08:41.60,Default,,0000,0000,0000,,if you heal a burn within 21 days, \N78% will have scarring.
Dialogue: 0,0:08:41.60,0:08:45.14,Default,,0000,0000,0000,,Why wait 3 weeks? \NTime matters.
Dialogue: 0,0:08:45.14,0:08:47.20,Default,,0000,0000,0000,,People die waiting.
Dialogue: 0,0:08:47.20,0:08:49.31,Default,,0000,0000,0000,,And so we started \Nin the skin lab in 1993,
Dialogue: 0,0:08:49.31,0:08:52.36,Default,,0000,0000,0000,,and our first sheets \Nwe grew in 10 days.
Dialogue: 0,0:08:52.36,0:08:55.71,Default,,0000,0000,0000,,But before long we realised, \Nby observation,
Dialogue: 0,0:08:55.71,0:08:57.79,Default,,0000,0000,0000,,by taking basic signs \Nto the bed side,
Dialogue: 0,0:08:57.79,0:09:01.42,Default,,0000,0000,0000,,we saw that the more immature \Nthose skin cells were,
Dialogue: 0,0:09:01.42,0:09:03.96,Default,,0000,0000,0000,,paradoxically, \Nthe better they did.
Dialogue: 0,0:09:03.96,0:09:06.11,Default,,0000,0000,0000,,And so we started doing \Nexperiments around this.
Dialogue: 0,0:09:06.11,0:09:09.88,Default,,0000,0000,0000,,Trying to understand \Nwhat was going on.
Dialogue: 0,0:09:09.88,0:09:14.45,Default,,0000,0000,0000,,And then we started seeing that if we take\Nthe cells after 5 days in the laboratory,
Dialogue: 0,0:09:14.45,0:09:18.02,Default,,0000,0000,0000,,and remove them \Nfrom the flask into a soup,
Dialogue: 0,0:09:18.02,0:09:20.52,Default,,0000,0000,0000,,that they did even better.
Dialogue: 0,0:09:20.52,0:09:28.84,Default,,0000,0000,0000,,And the operating theaters we work in, \Nare round about 44 degrees -- that's C[elsius],
Dialogue: 0,0:09:28.84,0:09:31.82,Default,,0000,0000,0000,,because if a patient gets cold,
Dialogue: 0,0:09:31.82,0:09:34.16,Default,,0000,0000,0000,,they no longer clot their blood,
Dialogue: 0,0:09:34.16,0:09:36.30,Default,,0000,0000,0000,,and so we can't operate.
Dialogue: 0,0:09:36.30,0:09:38.62,Default,,0000,0000,0000,,So I came out of the sweat box,
Dialogue: 0,0:09:38.62,0:09:42.59,Default,,0000,0000,0000,,I walked into the lab to see Marie \Nin the beautiful air conditioned lab,
Dialogue: 0,0:09:42.59,0:09:43.88,Default,,0000,0000,0000,,it was all clean,
Dialogue: 0,0:09:43.88,0:09:45.87,Default,,0000,0000,0000,,and in the operating room \Nwe debride,
Dialogue: 0,0:09:45.87,0:09:49.97,Default,,0000,0000,0000,,we remove the burn tissue until such point \Nthat we get pin point bleeding
Dialogue: 0,0:09:49.97,0:09:53.00,Default,,0000,0000,0000,,and then we know it's alive.\NSomewhat less than subtle.
Dialogue: 0,0:09:53.00,0:09:58.04,Default,,0000,0000,0000,,But our advances in that area are \Nanother 18 minutes at another time.
Dialogue: 0,0:09:58.04,0:10:00.55,Default,,0000,0000,0000,,And so there we were, \Nand I shook my head and said,
Dialogue: 0,0:10:00.55,0:10:04.13,Default,,0000,0000,0000,,"Wow, we just should just \Nspread this stuff on."
Dialogue: 0,0:10:04.13,0:10:08.34,Default,,0000,0000,0000,,The time taken to make sure \Nthose cells were on the right way up,
Dialogue: 0,0:10:08.34,0:10:13.82,Default,,0000,0000,0000,,fixing each patch onto the body \Nso they didn't sheer or move.
Dialogue: 0,0:10:13.82,0:10:19.34,Default,,0000,0000,0000,,Taking it from there, putting in a soup, \Ntrying to keep the soup under the dressings.
Dialogue: 0,0:10:19.34,0:10:23.42,Default,,0000,0000,0000,,At that stage, you gain a whole raft\Nof more experiments to do.
Dialogue: 0,0:10:23.42,0:10:25.31,Default,,0000,0000,0000,,How can we actually deliver cells
Dialogue: 0,0:10:25.31,0:10:27.27,Default,,0000,0000,0000,,to the surface \Nof this burned wound, such
Dialogue: 0,0:10:27.27,0:10:30.38,Default,,0000,0000,0000,,that they are alive and functional?
Dialogue: 0,0:10:30.38,0:10:35.56,Default,,0000,0000,0000,,We took, became I guess, \Namateur physicists,
Dialogue: 0,0:10:35.56,0:10:39.14,Default,,0000,0000,0000,,looking at the vortex in, \Nand apertures, in various nozzles,
Dialogue: 0,0:10:39.14,0:10:43.27,Default,,0000,0000,0000,,we found a nozzle, \Nin a chemist shop in Perth,
Dialogue: 0,0:10:43.27,0:10:46.17,Default,,0000,0000,0000,,that was from an Italian \Nmouth freshener.
Dialogue: 0,0:10:46.17,0:10:50.70,Default,,0000,0000,0000,,And when you put that nozzle \Non a 5 ml standard hospital seringue,
Dialogue: 0,0:10:50.70,0:10:53.74,Default,,0000,0000,0000,,the cells coming through that system \Nwith no dead space,
Dialogue: 0,0:10:53.74,0:10:58.14,Default,,0000,0000,0000,,were viable,\N90% plus cells were viable.
Dialogue: 0,0:10:58.14,0:11:00.10,Default,,0000,0000,0000,,It was a eureka moment.
Dialogue: 0,0:11:00.10,0:11:06.09,Default,,0000,0000,0000,,In the program you'll see\Nfine dots behind my name.
Dialogue: 0,0:11:06.09,0:11:10.21,Default,,0000,0000,0000,,Just off screen is the seringue \Nas we're spraying those cells on.
Dialogue: 0,0:11:10.21,0:11:15.77,Default,,0000,0000,0000,,So what we do, we take the skin cells \Nfrom you, to you.
Dialogue: 0,0:11:15.77,0:11:18.61,Default,,0000,0000,0000,,It avoids all the issues of rejection,
Dialogue: 0,0:11:18.61,0:11:20.82,Default,,0000,0000,0000,,it allows tissue expansion.
Dialogue: 0,0:11:20.82,0:11:24.46,Default,,0000,0000,0000,,Each little cell can cover \Nmuch greater area
Dialogue: 0,0:11:24.46,0:11:27.45,Default,,0000,0000,0000,,than when we coalesce them into a sheet, \Nand then grow them
Dialogue: 0,0:11:27.45,0:11:31.26,Default,,0000,0000,0000,,and the next step in the whole process\Nwas to look back,
Dialogue: 0,0:11:31.26,0:11:34.39,Default,,0000,0000,0000,,and say, "We can do this in 5 days."
Dialogue: 0,0:11:34.39,0:11:36.01,Default,,0000,0000,0000,,But 5 days is a long time.
Dialogue: 0,0:11:36.01,0:11:39.20,Default,,0000,0000,0000,,I've said already one day in a burns unit\Nis a day too long.
Dialogue: 0,0:11:39.20,0:11:41.50,Default,,0000,0000,0000,,How can we actually move quicker?
Dialogue: 0,0:11:41.50,0:11:43.57,Default,,0000,0000,0000,,We notice that our smaller burns \Nby this stage,
Dialogue: 0,0:11:43.57,0:11:46.61,Default,,0000,0000,0000,,we were looking at these technologies \Nin our smaller wounds,
Dialogue: 0,0:11:46.61,0:11:51.08,Default,,0000,0000,0000,,how where we were still doing \Nour traditional skin grafting,
Dialogue: 0,0:11:51.08,0:11:53.66,Default,,0000,0000,0000,,they had scars that were worse \Nthan larger burns
Dialogue: 0,0:11:53.66,0:11:55.72,Default,,0000,0000,0000,,where we were doing \Nmore advanced technology,
Dialogue: 0,0:11:55.72,0:11:57.29,Default,,0000,0000,0000,,where we were mixing the technologies,
Dialogue: 0,0:11:57.29,0:12:00.100,Default,,0000,0000,0000,,where we were using this traditional, \Nand the cells spray.
Dialogue: 0,0:12:00.100,0:12:02.85,Default,,0000,0000,0000,,And so we then moved to say,
Dialogue: 0,0:12:02.85,0:12:05.96,Default,,0000,0000,0000,,"How can we do it \Nin less than 5 days?"
Dialogue: 0,0:12:05.96,0:12:09.47,Default,,0000,0000,0000,,So we took the absolutely \Nkey essential components
Dialogue: 0,0:12:09.47,0:12:13.21,Default,,0000,0000,0000,,of the laboratory, \Nwe minutarised them.
Dialogue: 0,0:12:13.21,0:12:17.08,Default,,0000,0000,0000,,We put them in a box, \Na box just this big.
Dialogue: 0,0:12:17.08,0:12:20.18,Default,,0000,0000,0000,,The box that heats the enzyme \Nup to the required temperature,
Dialogue: 0,0:12:20.18,0:12:22.30,Default,,0000,0000,0000,,such that the skin\Nthat we harvest,
Dialogue: 0,0:12:22.30,0:12:25.71,Default,,0000,0000,0000,,we take a split thickness skin graft,\Na small postage stamp.
Dialogue: 0,0:12:25.71,0:12:27.46,Default,,0000,0000,0000,,We put that in the enzyme,
Dialogue: 0,0:12:27.46,0:12:31.09,Default,,0000,0000,0000,,takes few -- \Na matter of minutes, 10 to 15,
Dialogue: 0,0:12:31.09,0:12:33.82,Default,,0000,0000,0000,,20 if the skin is a little thick.
Dialogue: 0,0:12:33.82,0:12:36.71,Default,,0000,0000,0000,,And we take that out, \Nit's like a bread and butter sandwich,
Dialogue: 0,0:12:36.71,0:12:39.64,Default,,0000,0000,0000,,and we could peel those slices \Nof the skin apart,
Dialogue: 0,0:12:39.64,0:12:42.66,Default,,0000,0000,0000,,like we'd peel the sandwich apart,
Dialogue: 0,0:12:42.66,0:12:45.39,Default,,0000,0000,0000,,and the butter is all those \Nactively growing cells.
Dialogue: 0,0:12:45.39,0:12:48.58,Default,,0000,0000,0000,,Those cells under normal conditions \Nwill keep us whole.
Dialogue: 0,0:12:48.58,0:12:51.35,Default,,0000,0000,0000,,They will keep replenishing the surface \Nagainst the knocks
Dialogue: 0,0:12:51.35,0:12:53.59,Default,,0000,0000,0000,,and the scrapes of everyday life.
Dialogue: 0,0:12:53.59,0:12:56.64,Default,,0000,0000,0000,,We harvest those cells,\Nfilter them through,
Dialogue: 0,0:12:56.64,0:13:00.20,Default,,0000,0000,0000,,make them into a suspension,\Nand deliver them to the wound.
Dialogue: 0,0:13:00.20,0:13:03.86,Default,,0000,0000,0000,,The whole process now \Ntakes 30 minutes. \N
Dialogue: 0,0:13:03.86,0:13:12.62,Default,,0000,0000,0000,,(Applause)
Dialogue: 0,0:13:12.62,0:13:17.32,Default,,0000,0000,0000,,So, I'm a great believer in \Nlearning from today's experience
Dialogue: 0,0:13:17.32,0:13:20.09,Default,,0000,0000,0000,,to make tomorrow a better place.
Dialogue: 0,0:13:20.09,0:13:21.87,Default,,0000,0000,0000,,That tomorrow, every morning, \Nwhen you get up,
Dialogue: 0,0:13:21.87,0:13:23.95,Default,,0000,0000,0000,,it's the start of a new journey.
Dialogue: 0,0:13:23.95,0:13:25.76,Default,,0000,0000,0000,,So, where to now?
Dialogue: 0,0:13:25.76,0:13:29.79,Default,,0000,0000,0000,,Where to when we stand back and look \Nat 20 years of our work --
Dialogue: 0,0:13:29.79,0:13:32.27,Default,,0000,0000,0000,,Where to next?
Dialogue: 0,0:13:32.84,0:13:36.59,Default,,0000,0000,0000,,I had this idea that when I was \Nchasing scar-less healing,
Dialogue: 0,0:13:36.59,0:13:38.82,Default,,0000,0000,0000,,having seen that boy in 1985.
Dialogue: 0,0:13:38.82,0:13:40.28,Default,,0000,0000,0000,,I would get to the top of the mountain,
Dialogue: 0,0:13:40.28,0:13:42.12,Default,,0000,0000,0000,,20 years more no trouble,
Dialogue: 0,0:13:42.12,0:13:44.30,Default,,0000,0000,0000,,we plant the flag \Nat the top of the mountain,
Dialogue: 0,0:13:44.30,0:13:46.66,Default,,0000,0000,0000,,but my goodness, \NI was wrong.
Dialogue: 0,0:13:46.66,0:13:48.19,Default,,0000,0000,0000,,Because as we've changed \Nthe goalpost,
Dialogue: 0,0:13:48.19,0:13:51.49,Default,,0000,0000,0000,,people survive more and more \Nand more massive injuries.
Dialogue: 0,0:13:51.49,0:13:56.08,Default,,0000,0000,0000,,And we're chasing that illusive goal \Nfor more complex situations.
Dialogue: 0,0:13:56.08,0:14:00.06,Default,,0000,0000,0000,,And so I put it to you:\Nyes, we've got the cells in the right place,
Dialogue: 0,0:14:00.06,0:14:02.12,Default,,0000,0000,0000,,but where to next?
Dialogue: 0,0:14:02.12,0:14:07.66,Default,,0000,0000,0000,,What create, what self-organizing \Nsystems makes me this shape?
Dialogue: 0,0:14:07.66,0:14:09.50,Default,,0000,0000,0000,,Recognizable through life,
Dialogue: 0,0:14:09.50,0:14:11.22,Default,,0000,0000,0000,,a little bit bigger, \Na little bit smaller.
Dialogue: 0,0:14:11.22,0:14:13.69,Default,,0000,0000,0000,,But essentially recognizable \Nthrough life.
Dialogue: 0,0:14:13.69,0:14:16.08,Default,,0000,0000,0000,,From the embryo to death?
Dialogue: 0,0:14:16.08,0:14:19.66,Default,,0000,0000,0000,,What self-organizes this systems? \NWell, we started looking.
Dialogue: 0,0:14:19.66,0:14:24.38,Default,,0000,0000,0000,,We understand \Nthat if you are burnt here,
Dialogue: 0,0:14:24.38,0:14:28.05,Default,,0000,0000,0000,,the nerve density \Nin the nerves of the scar
Dialogue: 0,0:14:28.05,0:14:30.54,Default,,0000,0000,0000,,and on the non-scarred \Nmatched area are the same.
Dialogue: 0,0:14:30.54,0:14:33.40,Default,,0000,0000,0000,,They're both decreased.
Dialogue: 0,0:14:33.40,0:14:35.40,Default,,0000,0000,0000,,I know that if you have a burn,
Dialogue: 0,0:14:35.40,0:14:41.74,Default,,0000,0000,0000,,in your right upper limb, the patterning \Nof your left brain has changed.
Dialogue: 0,0:14:41.74,0:14:43.42,Default,,0000,0000,0000,,So where to next?
Dialogue: 0,0:14:43.42,0:14:45.20,Default,,0000,0000,0000,,We've got the cells in the place.
Dialogue: 0,0:14:45.20,0:14:46.94,Default,,0000,0000,0000,,We've got the architectural frameworks,
Dialogue: 0,0:14:46.94,0:14:51.00,Default,,0000,0000,0000,,as I work with colleagues in nanotechnology\Nlooking at self-assembly,
Dialogue: 0,0:14:51.00,0:14:54.02,Default,,0000,0000,0000,,a framework such that the cells \Ncan express themselves
Dialogue: 0,0:14:54.02,0:14:56.27,Default,,0000,0000,0000,,through an appropriate phenotype.
Dialogue: 0,0:14:56.27,0:15:00.09,Default,,0000,0000,0000,,Such as not only can we seal\Nthe surface, giving life,
Dialogue: 0,0:15:00.09,0:15:04.52,Default,,0000,0000,0000,,but that we can develop \Nthe underlayers of the skin,
Dialogue: 0,0:15:04.52,0:15:07.57,Default,,0000,0000,0000,,which give the quality of life.
Dialogue: 0,0:15:07.57,0:15:09.76,Default,,0000,0000,0000,,Then we can organize,
Dialogue: 0,0:15:09.76,0:15:13.85,Default,,0000,0000,0000,,we can self-organize \Nback to the original shape
Dialogue: 0,0:15:13.85,0:15:17.23,Default,,0000,0000,0000,,And is the 3-dimensional spacial information \Nfor that original shape
Dialogue: 0,0:15:17.23,0:15:20.81,Default,,0000,0000,0000,,actually housed in \Nthe homunculus in the brain?
Dialogue: 0,0:15:20.81,0:15:24.11,Default,,0000,0000,0000,,I know also, \Nfrom personal experience,
Dialogue: 0,0:15:24.11,0:15:27.91,Default,,0000,0000,0000,,when I was being scanned,\Nthe day after I had a tooth out
Dialogue: 0,0:15:27.91,0:15:31.100,Default,,0000,0000,0000,,that the pain blunts \Nand changes the neuro-plasticity
Dialogue: 0,0:15:31.100,0:15:35.08,Default,,0000,0000,0000,,such that the patterning \Nis lost temporarily.
Dialogue: 0,0:15:35.08,0:15:38.27,Default,,0000,0000,0000,,How can we with visualization,
Dialogue: 0,0:15:38.27,0:15:41.03,Default,,0000,0000,0000,,with active stimulation,
Dialogue: 0,0:15:41.03,0:15:43.28,Default,,0000,0000,0000,,think ourselves whole?
Dialogue: 0,0:15:43.28,0:15:45.20,Default,,0000,0000,0000,,We put the cells in place,
Dialogue: 0,0:15:45.20,0:15:47.21,Default,,0000,0000,0000,,the framework in place,
Dialogue: 0,0:15:47.21,0:15:50.08,Default,,0000,0000,0000,,but there are so many things\Nwe need to do.
Dialogue: 0,0:15:50.08,0:15:52.35,Default,,0000,0000,0000,,But that's an 18-minutes in the future.
Dialogue: 0,0:15:52.35,0:15:53.50,Default,,0000,0000,0000,,Thank you very much indeed.
Dialogue: 0,0:15:53.50,0:15:56.78,Default,,0000,0000,0000,,(Applause)