The novel of skin bank establishment in a referral burn center in a developing country

سال انتشار: 1397
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 313

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NCBMED08_012

تاریخ نمایه سازی: 18 تیر 1398

چکیده مقاله:

Introduction: The amount of tissue transplantation is estimated about 3-5 million tissues each year in the world. Only a single donor’s tissue may save or improve lives of one hundred patients. Loss of an effective tissue procurement program in many countries like Iran, may lead to loss of many thousands valuable tissues each year. In many countries, there isn’t any active tissue procurement program and the refusal rate for tissue donation is higher than organ donation. The problem of refusal of consent to skin procurement is more prominent due to the fear of having a raw appearance after skin harvesting. In contrary to the high prevalence of burn in Iran, skin procurement, preservation and transplantation are not well established in this country.Materials and Methods: Organ procurement unit of Mashhad University of Medical Sciences is the only coordinator unit for organ and tissue procurement in Khorasan Razavi province in the northern east of Iran. To evaluate the rate of skin donation in Mashhad in comparison to other organs and tissues, we extracted data related to tissue and organ procurement in Mashhad from 2001. Then we evaluated the yearly skin allograft needs in the burn department of Imam Reza hospital as the only referral burn unit in the northern east of Iran.Results: Information about skin procurement and transplantation in Iran is scattered. We could not find any information about skin procurement and transplantation in academic or governmental websites of our country. Potential brain dead solid organ donors are estimated between 40 and 60 per million population (PMP). Brain dead potential donation rate of Mashhad in the years 2007–2014 was about 33 PMP. The mean refusal rate in those years was 51%. Of patients who gave consent to donation, more than 86 percent consented to skin donation. Skin allograft procured from 272 (37%) of candidates. The average yield of skin retrieval per cadaver was 1525 cm2 with a gradual increase from 1400 cm2 in the first year to 1800 cm2 in the last year. If cornea retrieval rate is considered as standard, skin retrieval rate is about 93% of the standard.Conclusion: Governmental support of skin procurement and transplantation programs especially nonprofit programs may improve skin procurement rate and save more lives of severely burnt patients. We could absorb financial support of philanthropists for establishing a skin bank in our hospital and could improve the amount of procured skin by training procurement personnel in the operating room of the burn center. As a result, harvested skin allograft increased from 1400 to 1800 cm2 per cadaver. It is estimated that about 1 cm2 of skin allograft is needed for any cm2 burnt body surface area. Considering more than 900 acute burn patients (with mean burnt TBSA about 30%) in our burn center, the patients need for skin allograft would be more than 4.5 million cm2, annually. The amount of skin procurement in Mashhad has been currently about 110,000 cm2 in the last year of study. It shows that our patients demand is far from more than supply.

نویسندگان

Ali Ahmadabadi

Burn Surgeon