Skin provides coverage and protection of the body for water loss and infection. In burn injury, skin grafting is required for deep burn to enhance wound healing and restore normal skin function. Skin grafting can be harvested from remaining unburned area. With major burn of large area involvement, the harvested skin can be meshed to expand the area of coverage. Sometimes repeated harvesting will be required to provide adequate skin for wound coverage and healing.
In patients with large area of burn involvement, there may not be adequate unburned skin for harvesting and time is required for the donated area to recover. The use of donated skin will allow temporary coverage and protection of the burn wound. In addition, the donated skin can provide a template for regeneration, although rejection is usually a concern.
The Queen Mary Skin Bank is run by the Plastic and Reconstructive Surgery Division of Queen Mary Hospital. Established in 1996 by donation fund, it provides donated cadaveric skin for management of major burn injuries.
In general, skin donation involves 4 processes: harvesting, processing, storage and retrieval for usage.
Skin harvesting is performed in deceased donor within 12 hours of death in the operation theatre under sterile technique. The skin is harvested from coverage area such as trunk, thighs, upper legs, arms and forearms. Only a superficial partial thickness skin is harvested and the remaining skin is still intact. The skin is then processed with computerized freezer to -90 degree Celsius and stored at below -140 degree Celsius in a storage freezer. The cryo-preserved skin is banked for later usage. When indicated in extensive burn care, the donated skin is retrieved and used as a sandwiched graft with patient’s own skin to cover the wound to enhance wound healing.
Donated cadaveric skin is important for care of major burn. It provides coverage and assists wound healing. Hence skin donation is as important as other organ donation.