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Donor skin buys time for burn victims (The Straits Times, Mind Your Body, 4 April 2013, Pg 10)

04 Apr 2013

 

The use of donated skin on people with serious burns has been found to reduce the death rate and shorten their hospital stay by 20 to 50per cent, said Associate Professor Tan Bien Keem, the head and senior consultant in plastic, reconstructive and aesthetic surgery at Singapore General Hospital (SGH).

Donated skin is used to cover the wound after the burn surgeon has removed all the burnt and dead skin.
The donated skin provides an initial skin graft to heal the wound, protect against infection, reduce fluid loss and relieve the pain, said Prof Tan.

Patients with burn injuries are at high risk of infections of varying degrees of severity because the protective barrier afforded by the skin is lost, he said.

The body’s immune system rejects parts of the donor graft after about three weeks and these areas are then replaced with skin from another area of the victim’s own body.

Using donor skin buys time for burn victims so that their own skin need not be harvested until their condition is more stable, said Prof Tan.

Since 1998, the SGH Burns Centre, the national and regional centre for major burn injuries, has been using donated skin from the SGH Skin Bank as a first-line cover for serious burns.

Burn injuries are considered serious when 20per cent or more of the body surface area is affected.

The mortality rate varies, ranging from 5 to 10per cent for those with 20 per cent of their body surface affected to almost 100 per cent for those with 80 per cent and more of their body surface affected.

At the moment, the demand for donated skin to treat burns in Singapore outstrips the local supply.

Only about 20 per cent of the donated skin at the SGH Skin Bank is from local donors.

While the bank makes up the shortfall from overseas skin banks, it hopes to increase the number of pledges for skin donation, through the burns support group and other activities.

It is good to be more self-sufficient because one never knows when overseas stocks may become depleted, said Prof Tan.

The skin is typically harvested from the dead person within 15 hours of death.

Only about 0.025cm to 0.046cm of the outer layer of the skin is harvested using a special instrument called the dermatome.

The skin is taken from the hidden areas of the body, such as the back and thighs, so that the donor can still have an open casket funeral.

Donated skin pieces are washed, treated with antibiotics, processed and individually packed in special sterile bags. These bags are stored in special freezers.

Unlike the heart, liver, kidneys and corneas – which are covered under the Human Organ Transplant Act (Hota) – skin is covered under the Medical (Therapy, Education and Research) Act or MTERA.

Under Hota, the kidneys, livers, corneas and hearts of Singaporeans and permanent residents aged 21 to 60, who become brain dead, can be automatically taken for transplant – unless these individuals have opted out of the scheme earlier.

Under MTERA, however, donation can take place only when the next-of-kin gives consent upon the person’s death or when the person pledges to give his skin while he is alive.

MTERA also covers heart valves, lungs and bones.
To find out more or sign up as a skin donor, call the SGH skin donation coordinator at 6321-4974.

For more information on organ and tissue donation in general, call SingHealth Transplant on 6326-5195 or the National Organ Donor Registry on 6321-4390.

Read the original article here

 

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Last Modified Date :26 Sep 2013