In 2006, Dr. Gladstone who represented Blade and Light, was flown down to Santiago, Chile to perform Mohs Surgery on a courageous patient named Alejandro who suffered from Epidermolysis Bullosa. In addition, skin care, wound care, and infection challenges with this disease, the patients are at a very high risk for squamous cell carcinoma. Squamous cell carcinoma causes tremendous morbidity in these patients, and is a leading cause of mortality. Many patients require amputations in order to “stay ahead” of the cancers. However, this strategy causes significant functional problems.
Alejandro had several such surgeries. He had only one digit left. He used this remaining digit to type and support his mother and family. Unfortunately, the cancer attacked his remaining digit. It was felt that Mohs Surgery, which has the highest cure rate for squamous cell carcinoma, and could save skin due to examining 100% of the margin was the best option to save Alejandro’s finger. While Mohs surgery is usually performed under local anesthesia, because skin in patients with EB is very sensitive, the Mohs Surgery was performed under general anesthesia in an operating room.
Because of the urgency of situation, Dr. Gladstone performed the surgery the same day he arrived in Santiago. After seven and half hours, he was able to clear the tumor while saving Alejandro’s finger. Dr. Gladstone collaborated with Dr. Francis Palisson, the Director of the South American Division of DEBRA. Dr. Palisson pioneered the use of placenta as a cost effective method for wound healing. This technique was used to enhance the healing of Alejandro’s hand and digit after the Mohs surgery.