Indian Journal of Burns

EDITORIAL
Year
: 2018  |  Volume : 26  |  Issue : 1  |  Page : 1--2

Skin bank – the need of hour for burn treatment


Vijay Kumar 
 Department of Plastic Surgery, King George Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
Prof. Vijay Kumar
1/78, Vishesh Khand, Gomti nagar, Lucknow - 226 010, Uttar Pradesh
India




How to cite this article:
Kumar V. Skin bank – the need of hour for burn treatment.Indian J Burns 2018;26:1-2


How to cite this URL:
Kumar V. Skin bank – the need of hour for burn treatment. Indian J Burns [serial online] 2018 [cited 2019 May 25 ];26:1-2
Available from: http://www.ijburns.com/text.asp?2018/26/1/1/253857


Full Text



The largest organ of the body is skin. A person can survive with more than 60% damage to other organs, such as liver and kidney, but loss of 40% of the skin may be fatal, unless the tissue is replaced.

The skin in a major burn patient is deficient even after meshing of skin graft. Available skin substitutes such as Integra may be not economical for burn patients; skin cultures may be available in limited quantity, in few centers. In such situation, cadaveric skin graft may be the major source of the skin.

In India, more than 1 million cases of burn injuries are reported every year, and most of them require skin cover.[1]

In case of deficient donor skin, immediate early excision and cover can be done with allograft. This is done to protect the excised area and to prepare the wound for future autograft take. Allograft can be used for coverage of wound or it can be used with autograft as “sandwich technique.”[2] In this technique, both the autograft and allograft adhere to the wound bed, and autologous epithelium grows through the meshed autograft, while allograft separates off the wound bed. The allograft reduces fluid, electrolyte, and protein loss, reduces potential infectious disease transmission, prevents tissue desiccation, suppresses bacterial proliferation, reduces pain, reduces energy requirements, stimulates epithelialization, and prepares wounds for definitive cover.

Skin banking is a process in which skin grafts are harvested from a cadaveric donor and stored (banked) for future use. The skin from a donor is generally harvested within 6 h of death, stored in glycerol,[3] and then taken to a skin bank. There it undergoes processing, and is stored in skin bank, where after processing it is stored in skin bank.

The first tissue bank in Europe, the Yorkshire Regional Tissue Bank, was established in England in 1960; the Dutch National Skin Bank in The Netherlands followed this, in October 1976. With the further evolution of techniques to preserve skin, the Euro Skin Bank was opened in 1992.[4],[5],[6],[7],[8]

In India, the first deceased donor skin bank was established in 2000 at Mumbai, which was only one skin bank till 2009. In 2009, a collaboration of the National Burns Centre Mumbai,[9] Rotary International, and Euro Skin Bank developed an effective model of skin bank and started functioning in 2013. The success of this model resulted in further promotion of skin bank in Maharashtra, Karnataka, and Tamil Nadu.

Other skin banks working are at Choithram Hospital, Indore; Ganga Hospital, Coimbatore; Government Stanley Hospital, Chennai; Orange City Hospital, Nagpur; Right Hospitals, Chennai, Surya Sahyadri Hospital, Pune; and Victoria Hospital, Bangalore, Cuttack, Bengaluru, also in the hospital at Cuttack, and Bengaluru.

Most of the burn patients are economically poor in India. The dressing material usually dictates the treatment cost. Due to this factor, the use of allograft skin can be economical and also save the life of the patient.

There is a huge gap in demand and supply of the required allograft skin, with more and more skin banks are needed in various parts of India.

Nowadays, organ donation of the kidney, liver, and eye is becoming common, and skin donation should also be promoted. Awareness program for the public about skin donation [10] should be emphasized along with organ donation. Various nongovernmental organizations, print media, radio, and television media should be used to spread the knowledge about skin donation

References

1Keswani SM, Mishra MG, Karnik S, Dutta S, Mishra M, Panda S, et al. Skin banking at a regional burns centre-the way forward. Burns 2018;44:870-6.
2Rogers AD, Allorto NL, Adams S, Adams KG, Hudson DA, Rode H, et al. Isn't it time for a cadaver skin bank in South Africa? Ann Burns Fire Disasters 2013;26:142-6.
3Cai L, Long C, Karki B, Nakarmi K, Iqbal A, Casertano M, et al. Creation of Nepal's First Skin Bank: Challenges and outcomes. Plast Reconstr Surg Glob Open 2017;5:1-7.
4De Backere AC. Euro skin bank: Large scale skin-banking in Europe based on glycerol-preservation of donor skin. Burns 1994;20 Suppl 1:S4-9.
5Hoekstra MJ, Kreis RW, du Pont JS. History of the euro skin bank: The innovation of preservation technologies. Burns 1994;20 Suppl 1:S43-7.
6Pianigiani E, Ierardi F, Cherubini Di Simplicio F, Andreassi A. Skin bank organization. Clin Dermatol 2005;23:353-6.
7Castagnoli C, Alotto D, Cambieri I, Casimiri R, Aluffi M, Stella M, et al. Evaluation of donor skin viability: Fresh and cryopreserved skin using tetrazolioum salt assay. Burns 2003;29:759-67.
8Chua A, Song C, Chai A, Chan L, Tan KC. The impact of skin banking and the use of its cadaveric skin allografts for severe burn victims in Singapore. Burns 2004;30:696-700.
9Gore MA, De AS. Deceased donor skin allograft banking: Re-sponse and utilization. Indian J Plast Surg 2010;43:S114-20.
10Gore M. Cadaver skin donation and skin bank. Indian Journal of Burns 2017;25:3-5.