Skin Donation
Skin Bank 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 bestsubstitute 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

What is Skin Bank?

A place where skin collected from eligible deceased donor is processed, preserved and distributed as per INTERNATIONAL PROTOCOLS.

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 Centre (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.
Checking  harvested skin
Pieces of skin in 85% glycerol
In shaking incubator
Procedure followed for Retrieval:
Shaving
Scrubbing with Betadine
Cleaning with Savlon
Cleaning with Sterilium
Lubricating with paraffin Oil
Harvesting Skin
Preserving skin in 50% glycerol
Phase II: To check harvested skin and to lubricate it properly.
All pieces of skin are kept in 85% glycerol.
The skin with 85% glycerol is kept under shaking conditions for 3 hrs. at 33°C in shaking incubator.
After 3 hrs, the skin immersed in 85% glycerol is stored in freezer at 4° to 8°C for 2-3 weeks for glycerol to act on skin.

Cutting the Skin into regular size

Meshing of Thick Sking

 
 
 

Meshed Skin Preserved in
Small Sterile Container

Skin Processing Room
 
Administrative Office of Skin Bank
Cold-Room(Outer View)
Cold-Room(Inner View)
Storing Glycerol Preserved allograft in walk-in fridge
 
Phase III: Meshing and Final preservation of skin
After 2-3 weeks, the skin is taken out from freezer into bio safety cabinet.
The skin strips are trimmed properly, and its length, width, thickness is measured and thereafter put in sterile vials containing 85% glycerol.
The vials containing the glycerol preserved allograft(GPA) are labelled according to the thickness and dimensions of skin it contains.
The sealed vials are then stored in at 4°C to 8°C up to 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
Bio-Safety Cabinet

Mesher

Centrifuge

Sealer

 
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 Centre.

Once the call comes to National Burns Centre 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.
Skin retrieval team of National Burns Centre harvesting skin.
Skin Donation Vehicle: Our Ambasador
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
Unless we Donate Skin there is no value of Skin Bank so please donate Skin
DONATE SKIN & SAVE LIFE
 
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