Skin Donation
Skin Banking and Skin Donation
In a developing country like India, where the social inequalities among the genders are high about 7 million people suffer from burn injury every year. Out of this 80% are women and children. Rest 20% is men at factories and other work places.
Why Skin Donation?
In case of burns, SKIN – the primary protective barrier of the body – is destroyed and the body is exposed to infectious agents. If the burnt area is not immediately covered with some skin substitutes, then patients are prone to infection, fluid loss and ultimately death. In case of smaller percentage of burns (lesser total body surface area burnt), skin from the un-burnt area of the patient is taken out and put on the burn wound to cover it. But when burns percentage is more than 40% to 50%, then the patient’s own skin is not available to cover the burn wound. In that scenario we need some skin substitutes. It is said that skin is the best substitute for skin. Thus, Skin donated after death(cadaveric skin) is the best and cheapest substitute compared to artificial skin substitutes. Such skin is a temporary dressing. But, it is important as it helps in patient’s own skin to regenerate. 80% of such patients can be saved if we have enough skin in skin bank. Thus arises the need of skin donation. One can donate one’s skin after death to save someone else’s life.
Rotary Club of Bombay North (RCBN) Skin Bank
There was a great need of establishing a skin bank to collect process and preserve human cadaver skin donated after death. The processed donor skin helps immensely in the treatment of extensive burn. It has been observed that the surgical application donor skin on burn wound has improved the treatment outcome. Many patients who could not have been saved without donor skin are being saved now.
The Skin bank not only caters to NBC requirement but it also caters to the whole nation as there is no other skin bank of such high quality in the country today.
So, RCBN Skin Bank is a place where skin collected from eligible deceased donor is processed, preserved and distributed as per INTERNATIONAL PROTOCOLS.
Skin Bank
On 21st November, 2009, a state-of-the-art RCBN Skin Bank in Mumbai was established at National Burns Center in collaboration with Euro Tissue Bank. It was set-up with collaboration of Rotary Club of Bombay-North and Euro Skin Bank and Rotary Club of Leiden. The Inauguration of the Skin Bank was done by the Director of Euro Skin Bank Dr. Welsly Bodha.
RCBN Skin Bank is a place where skin collected from eligible deceased donor is processed, preserved and distributed as per INTERNATIONAL PROTOCOLS.
The Skin bank not only caters to NBC requirement but it also caters to the whole nation as there is no other skin bank of such high quality in the country today.
Procedure followed in Lab:
Phase I: Harvesting Skin
Skin donation Procedure: Skin donation is very simple procedure.
- Upon death of a possible donor, the next of his/her authorized kin needs to inform on the BURNS HELPLINE of National Burns Center (NBC): 022-27793333 (active 24 by 7).
- Upon receiving such a call, after checking for cause of death and contraindications, the Skin retrieval team will reach the place of death in a specialized Burns Ambulance. Death Certificate and Consent of relative is taken.
- Then, the retrieval team harvests the skin of the donor only from legs, thighs and back with a special instrument called DERMATOME. Only one eighth thickness of the skin is harvested so there is no disfiguring of body at all. It is not even visible to persons who come to pay their homage as after harvesting, the area is bandaged and the donor’s body is handed over to the next of the kin.
- This Procedure takes only about 45 minutes.
Procedure followed for Retrieval:
- Shaving,cleaning of the body.
- Scrubbing with Betadine
- Cleaning with Savlon
- Cleaning with Sterilium
- Lubricating with paraffin Oil
- Harvesting Skin using dermatome and Preserving skin in 50% glycerol
- Preserving skin in 50% glycerol
Phase II: Skin processing in glycerol
- All pieces of skin are checked and preserved in 85% glycerol.
Phase III:Final processing and preservation of skin
- The skin strips are trimmed properly, measured and thereafter put in labelled sterile vials containing glycerol.
- The sealed vials are then stored in at 4°C to 8°C upto 5 years.
Skin Donation Facts:
- Skin harvesting is done within 6 hours from the time of death.
- A very thin layer is harvested from both the legs, thighs and the back.
- There is no bleeding or disfigurement to the body.
- No MATCHING required for grafting. Long shelf life of 5 years
- The skin processing charges for cadaveric skin is very low as compared to commercially available synthetic skin substitutes.
Contraindications for Skin Donation:
- HIV & Hepatitis B & Hepatitis C
- STD’S
- Generalized infection & septicemia (Pneumonia, T.B, Etc)
- Any kind of skin infection
- Malignancy
- Evidence of skin cancer
How does the donated skin help burns patient?
- Prevents the entry of foreign infectious agents.
- Relieves pain.
- Controls the loss of fluid, protein, and heat from the body.
Ultimately it saves a life.
Instuments
Why so High Mortality Rate?<>
When some one sustains burns injury, the skin is burnt, so the barriers is broken and the body is thrown wide open to entry of infectious agents .If we do not cover the burnt area immidietly with some skin substitutes, then patients die of infection. It is said that skin is the best substitute for another skin. It is also the chiefest substitute compared to artificial skin substitutes. In india 100% mortality is observed in patients having more than 60% burns because patient’s own skin is not enough to cover burnt areas and In such a scenario the only option left is use somebody else’s skin (ALLOGRAFT). This skin can be taken from the living donors (relatives) but it is painful to take out the skin and leaves some scars behind. Therefore the best option in such a case is to have skin from dead bodies. (Cadaveric skin) This can cover the burns wounds although temporarily but will be instrumental in saving the life of such patients. 80% of such patients can be saved if we have enough skin in skin bank. There arises the need of skin donation, One can donate one’s skin after death to save someone else life. The donated skin is harvested within 6-12 hours of death, it is then brought to the skin bank laboratory for further processing and is finally preserved in liquid glycerol as long as 2-5 years.
Skin cannot be harvested from persons suffering from HIV, Skin infection, Cancer, Hepatitis.
Skin donation Procedure:
Skin donation is very simple procedure. After the death of a donor, the next of his/her authorized kin just need to call our burns helpline number 27643333 of National Burns Center.
Once the call comes to National Burns Center for skin donation, Our Skin retrieval team respond within half an-hour of receiving the call. They reach the place of death in a specialized Burns Ambulance. Consent of relative is taken & the retrieval team harvest the skin of the donor only from back and thigh with a special machine called DERMATOME. Only one eighth thickness of the skin is harvested so there is no disfiguring of body at all.It is not even visible to persons who come to pay their homage After the harvesting, the area is bandaged and the donor’s body is handed over to the next of the kin. This Procedure takes approximately 45 minutes.
Donors Name
- Rotary Club of Bombay North Charity Trust
- Rotary District General Fund
- Rotary Club of Bombay Central Charitable Trust
- Rotary Club of Chembur Charitable Trust
- Rotary Club of Deonar Mumbai Charity Trust
- Rotary Club of Worli Bombay Trust
- Rotary Club Of Bombay Bayview Charitable Trust
- Rotary Club Of Bombay Juhu Beach Public Charitable Trust