The Orange City Hospital in Nagpur, which housed the only skin bank in the Vidarbha region, has decided to shift the facility to the Government Medical College and Hospital (GMCH) since meagre skin donations made maintaining the hospital difficult.
The hospital currently has about 10,000 sq cm of donated skin preserved in the bank and as soon as it is utilised for patients, the facility will be shut down and equipment shifted to the GMCH. The hospital boasts of an advanced burns facility and recently treated the 25-year-old lecturer who was set ablaze by a stalker in Hinganghat. She, however, succumbed to her injuries on February 10.
Set up in 2016 under the guidance of the National Burns Centre in Airoli, the skin bank at Orange City Hospital received just five to six donations per year.
Expensive unit
“We are unable to maintain the bank due to scarcity of the donations. Since the government is ready to maintain the bank, we will be shifting all the equipment,” said Dr Darshan Rewanwar, chief consultant of plastic surgery and burns unit, adding that the monthly cost of just maintaining the skin bank runs up to ₹3 lakh even as it has little skin to preserve.
Burns patients suffer from severe skin damage and thus skin grafting becomes crucial to protect them from infections. “There is always a huge requirement of skin,” said Dr. Rewanwar.
Maharashtra has eight skin banks, the largest being at the National Burns Centre (NBC) in Airoli, which not only caters to the patients admitted with them but also other burns centres across the country.
Soaring demand
Plastic surgeon Sunil Keswani, who is heads the NBC said many patients are in need of skin grafts but there is not enough skin available. “For example, Mumbai records anywhere between 20 to 25 donations in a month. However, the actual requirement of the city is at least 150 donations in a month,” said Dr. Keswani.
Skin can be donated within six hours from the time of death and it is harvested from both the legs, thighs and the back. After consent for the donation is given, a skin bank team reaches the donor and harvests an extremely thin layer of skin, which consists of the epidermis and part of dermis. Experts say that the harvested skin is merely 0.4 to 0.6 mm in thickness.
“From one donor, we get about 2000 to 2500 sq cm of skin,” said Dr Keswani adding that on average, donations made by two donors get utilised for one patient requiring skin grafts.
Doctors say that lack of awareness is the main reason behind fewer skin donations, but some families aware about the concept often back out fearing disfigurement of the body. “People need to know more about the process. There is no bleeding when the skin is harvested and after the procedure is completed, the parts are bandaged carefully,” explained Dr. Keswani.
The harvested skin is collected in a solution and then taken to the skin bank where it is washed in an antiseptic and screened.
The strips of skin are then trimmed, measured, meshed and thereafter put in sterile vials containing glycerol.
Experts say that these vials can be stored for up to five years.