Our skin is the largest human organ. It gives us our sense of touch, our appearance and shape, and most importantly, it acts as a shield to protect us from heat and cold, as well as environmental impacts such as chemicals, the sun's UV-radiation and bacteria.
Under normal conditions, our skin is able to mend itself from the daily wear and tear. However, when the skin gets too badly burned or damaged, it is unable to repair itself without help. For patients with severe burn injuries, one way to promote healing is by covering the wound with allografts - skin from an organ donor.
Can skin be donated?
Many people do not realise that skin can be donated in the same manner as other organs or tissues upon a person's death. Advanced scientific techniques now allow for viable donor skin to be effectively frozen and stored for long periods, up to five years. The Burns Centre at the Singapore General Hospital has set up a Skin Bank for the harvesting, processing and preservation of cadaveric skin.
Using donated skin
In major burn injuries where insufficient skin grafts can be recovered from the patient, wound covering by fresh or stored allogenic human skin is preferred over the use of biosynthetic dressings. The donated skin can be used as a temporary dressing for severe burns to help relieve the patient's pain and discomfort. It also reduces the growth of bacteria and loss of critical fluid, and helps to improve a patient's morale and immunological state, until it is possible to do skin grafting using the patient's own skin.
In Singapore, the Burns Centre treats about 300 patients a year, most of whom suffer from burn injuries as a result of industrial or domestic accidents. Up to 15% of these patients sustained major burns, with a total area burns in excess of 30% body surface area, or full thickness burns in excess of 20% body surface area. These victims often include toddlers scalded by hot water at home, to adults badly burnt by chemicals or flames.
For these patients, donated skin can make the difference between life and death, by promoting healing of the wound while the patient's own skin is cultured for grafting. Without the donated skin used in the interim, many burns patients would die waiting for their own skin to be cultured for transplantation.
There is always a critical need for donor skin. It is our hope that more organ donors will consider donating skin. You can opt to donate your skin by signing up as a skin donor. Like any other organ, tissue or blood donation, your thoughtfulness may save someone's life.
How is skin harvested and stored?
Skin is procured from a deceased organ donor, just like any other donated organ.
In order for the tissue to be useful, it must be removed within 15 hours of death.
The screening of the potential donor includes checking of medical history and present illnesses, physical examination and blood sampling for serological investigations like HIV and hepatitis.
Only the outer skin is recovered during an asepetic surgical procedure, using special instrumentation. Typically thickness of the skin harvested varies between 0.025 cm to 0.046 cm - the thickness of a sunburnt peel.
The recovered skin pieces are processed and packed individually, and stored in a special freezer operating at temperatures ranging from -130ºC to -196ºC. The harvested skin pieces can be stored in these conditions for up to 5 years.
Will the body be disfigured?
The donor's body is treated with the utmost respect at all times. It should be noted that skin will not be recovered from exposed areas of the body like the face, neck and upper limbs of the body. After tissue recovery, the donor is appropriately prepared, allowing for an open casket funeral if desired.
Who can pledge to donate skin?
Anyone above the age of 18 can sign up as a skin donor. The pledge will only take effect upon death.
How do I sign up as a Skin Donor?
Once you have decided to make this gift of life, complete and sign an Organ Donation Card in the presence of two witnesses. Mail this self-addressing form and an Organ Donor Card will be issued to you by the Organ Donor Registry, Ministry of Health. Please carry this card with you at all times so that medical personnel can be instantly alerted to your wishes.
While we are all familiar with the life-saving concept of organ donation upon death, the fact that the thin patches of skin can also have life-or-death significance to countless burns victims may not occur to us.
We encourage you to consider this selfless act and to talk with your loved ones about signing up as a skin donor. If you have any concerns or queries, please feel free to contact our Skin Donation Co-ordinator at Tel: 6321-4974 or via email: gplskin@sgh.com.sg
If you have any other questions concerning donation of other organs, please call the Organ Donor Registry at Tel : 6321-4390.