UCLA plastic surgeons yesterday completed a series of bedside procedures to promote skin growth in sections of the formerly conjoined Guatemalan twins’ scalps that are healing slowly. Doctors at UCLA’s Mattel Children’s Hospital remain optimistic that Maria Teresa and Maria de Jesus Quiej Alvarez’s recovery is on track.

“We cleaned debris from Maria Teresa’s skin flaps and applied a special skin substitute that encourages cell growth and promotes rapid healing,� said Dr. Henry Kawamoto Jr., lead plastic and reconstructive surgeon for the twins’ medical team. Doctors performed the procedure at Maria Teresa’s bedside in the pediatric intensive care unit (PICU) after administering local anesthetic.

Surgeons had performed the same procedure on her sister, Maria de Jesus, during a routine surgery on Aug. 30. Maria de Jesus’ scalp has now grown enough to cover her entire skull and brain. UCLA physicians are hopeful that the skin substitute will enable Maria Teresa’s scalp to grow enough to completely cover her head before she goes home with her sister.

Donated to the twins’ cases by Johnson & Johnson, INTEGRA Dermal Regeneration Template is a skin replacement product designed to close wounds and regenerate the skin. INTEGRA is composed of a dermal layer of collagen fibers and a synthetic epidermal layer.

Both Maria Teresa and Maria de Jesus remain in serious condition with stable vital signs in the PICU at UCLA’s Mattel Children’s Hospital. Maria de Jesus likes to watch the nurses read books to her, eats solid food, holds her own bottle and interacts with visitors. Although she is recovering more slowly, Maria Teresa makes eye contact with visitors, reacts to touch and responds to musical toys.

UCLA doctors are cautiously optimistic about the twins’ long-term prospects for recovery. Surgeons separated the 1-year-old Guatemalan girls, born joined at the head, during a nearly 23-hour surgery on Aug. 6.