How to donate skin to burn victims

Miss Heather Cleland is the Head of the Victorian Adult Burns Unit at The Alfred Hospital in Melbourne. She and her team of plastic surgeons use donated skin from the Donor Tissue Bank of Victoria to treat severely ill patients suffering from non-healing burn wounds.

According to Miss Cleland the main two groups of burns patients are young male risk takers and the elderly and frail. The number of elderly patients is increasing due to the rising aged population in Victoria.

Donated skin is used as a last resort due to the shortage of this product. It’s reserved for situations where Miss Cleland and her colleagues can no longer use the synthetic skin products that are easily accessed. These are generally situations where a patient’s wounds are infected and synthetic skin wouldn’t be tolerated by the body’s immune system. Donated skin is an invaluable resource for these patients, as it aids in controlling infection, pain management and surgical reconstruction.

As a plastic surgeon and someone who has treated severely burned patients Miss Cleland truly appreciates how precious the gift of tissue donation can be. “Obviously, at a time when someone has died, it’s incredibly difficult for the people who cared about that person,” she said.

“It’s important, I think, to have the conversation before that time comes so that your family and all the people who care about you, know what your wishes are. If that time does arrive and they have been asked to consider donation, it makes it easier knowing what you wanted.”

‘And it’s also really an opportunity for people to make a gift at a time when there might not be a lot of other positives.’ Miss Cleland said.

More that 7 million people in India suffer from burn injuries every year. 80% of these are women and children. Amongst these are acid victims, dowry victims, accident victims and others whose skin has been badly burnt. It is the second largest group of injuries after road accidents, and every year nearly 1 to 1.5 lakh people get crippled and require multiple surgeries and prolonged rehabilitation due to burn injuries. Out of the 10% of these which are life threatening, around half will succumb to their injuries.

So what can you do about it? A lot. You can pledge to donate your skin after your death. You can make a skin donation of a loved one after they die and help someone get their life back. And it will cost you nothing but a little time.

Why is skin donation so important?

Our skin is the largest human organ. 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.

When the skin gets badly burned or damaged, it’s 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. Skin is needed to prevent infections, decrease pain and provide protection, and help faster healing and save lives. 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, 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. Therefore the need for skin substitutes. In emergencies when skin is not available, often relatives of patients offer their own skin, as a live donor.

Skin is the best substitute for skin. Thus, Skin donated after death is the best and cheapest substitute compared to artificial skin substitutes.

Such skin is a temporary dressing but is vitally 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 banks. Donating your skin after your death, instead of burning or burying your body would be a great service to millions who are suffering.

How can skin be donated?

Many people do not realise that skin can be donated in the same manner as corneas, organs or tissues upon death. Donor skin can be frozen and stored for long periods, up to five years. Cities in India such as Mumbai, which has a Skin Bank, can store the donor skin and make it available to all the burn victims who need it. The skin is only taken from the back, thighs and legs and does not in any way disfigure the body. Skin can be donated within in 6 hours from the time of death.

Here’s how it works.

Just like for eye donation, in event of death, the crew from the Skin Bank (if there is one in your city) can reach the location of the body. The Skin Bank Team will come to the donor’s home, hospital or morgue wherever the donor is kept. Skin Harvesting is performed by Skin donation Team consisting of one Doctor, two Nurses and one attendant.

They will check for cause of death and contraindications and the Death Certificate and Consent of relatives will be taken. At the time of skin harvesting, blood sample from the body of the deceased is also taken and necessary test for HIV, Viral markers & Hepatitis is carried out at the Skin Bank.

In a simple procedure that takes just around 45 minutes, they’ll remove the skin from the back, abdomen and the legs. Our skin has 8 layers, but only 1/8th, i.e. the uppermost layer of the skin is harvested. Thickness of skin removed is very small and there is no disfigurement of the body. It is not even visible to persons who come to pay their homage.

Who Can Be A Donor?

Anyone can be a donor irrespective of sex & blood group. The minimum age of the donor should be 18 years but there is no upper age limit. Even a 100-year-old person can donate his skin and it will be used for treatment. Only those suffering from HIV & Hepatitis B & Hepatitis C, STD’S, generalized infection & Septicemia (Pneumonia, T.B, Etc), any kind of skin infection, malignancy and having evidence of skin cancer, cannot donate.

Facts On Skin Donation:

• You don’t have to pay anything to the Skin Donation Team, selling & buying organs is illegal.
• Anyone’s skin can be transplanted on any one, there is no blood matching, no color matching, no age matching required.
• You need to produce the Death Certificate and its photocopy which will be evaluated by the Team Doctor before starting the procedure.
• There is no bleeding of disfigurement at the site where skin if harvested and the area is properly bandaged.
• Currently there are skin banks in Mumbai, Chennai and Bangalore.
• If there is no facility in your city for Skin Doctors to come home to retrieve the tissue, it can be done at a hospital.

What Can You Do?

You can register for a Donor Card at www.organindia.org and mention on it that you want to be a skin donor too. Tick the box that says Skin Donation. It IS NOT compulsory to register with anyone. The skin donation can be carried out irrespective once the call is made to the Skin Bank after Death.

The most important thing you can do is to TALK TO YOUR FAMILY. Convey to them that you want to be a skin donor, so that they respect your wishes. Please remember that it is the next of kin who will make that call to the skin bank, so they must know what you wanted. Read more about skin donation, know more about skin donation, and help spread the word to your friends and relatives!

Can you donate Skins?

Can skin be transplanted from one person to another?

Can be donated after death a skin organs?

How do skin banks work?