“People say beauty is skin deep, but, in fact, life is skin deep,” said A Mohammed Imran Khan, Plastic and Reconstructive surgeon at Burns Centre, Grace Kennett Foundationm
Speaking to The Hindu on the importance of skin donation, he said 70 lakh cases of burns are reported every year in India, out of which 1.4 lakh people die. With a skin cover, the healing and survival rate of a patient with severe burns improves by 50%.
There are 12 established skin banks in India. “In south Tamil Nadu, we are the first to perform allograft through our skin bank,” he said.
All the four cases of severe burns have been treated with a 90% success rate within eight months of active functioning of skin bank in the hospital.
Grafting of skin is of three types - autograft is where the patient’s own skin is used. Homograft is where the patient’s immediate family or genetic resemblance skin is used. Lastly, allograft is where skin is taken from the same species, eg., from human to human.
Three third degree burn patients who underwent surgery and were covered with allograft recovered within three weeks. Patients suffering from deeper burns or third degree burns will be best benefitted by skin grafting.
In one case, hot oil spilled on a two-year-old child. “Deeper burns involving 15% of the boy’s body surface were treated with removal of dead skin through surgery and covering the wound with skin bank allograft. Within three weeks, the boy recovered.” he said.
“We get excellent results in our treatment which is also cost-effective,” he said. Any skin graft other than the patient's own skin will get rejected in two to three weeks, he said. Then why graft? “If the raw or the burnt area is left open for bacteria to infect, multiple organ failure may occur, resulting even in death. Hence grafting of skin through any of these three methods acts as a temporary biological cover helping in epithelisation or natural healing process of human skin.”
Autograft is performed once the grafted skin falls off. Skin retrieved via autograft can be used immediately, whereas for allograft, it takes 44 days to be made fit to use. “As of now our skin bank has skin from the deceased which is retrieved within six hours of death. Retrieved skin can be preserved upto five years.,” he said.
Donation
All over India, skin banks require at least 5,000 donors in a year. A donor can donate up to 1,300 to 2,000 cm of their skin. One square cm of allograft costs ₹15 across the nation.
People above 18 years and free from a set of ailments can donate. Blood, colour or age matching is not required, he says. “We are short of donors due to lack of awareness among the public,” he said.
Donating skin is not a painful process as many fear. “Skin is harvested from specific areas - thigh region, back, occasionally from the chest, but never from the face, and only under anesthesia. After the donation, the donor has to wear a bandage for 14 days after which it will be removed painlessly. A high pigmented patch will remain which will change into the original skin colour within six months,” he said.
Out of the eight layers of human skin, only the uppermost layer is taken which is bound to regenerate like blood.
During our awareness campaigns in and around Madurai, people were hesitant at first, but after our sessions, many came forward to pledge, he adds.
“Nearly 20 people have pledged to donate since the inception of the skin bank at our hospital, which includes doctors and the public,” said R. Valentina Rani, skin bank in-charge.
“This is a sign of hope for people who think burnt skin is a forever scar on their body,” said Dr. Mohammed.
EOM
