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Setting up a Skin Bank

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Setting up a Skin Bank

  1. 1. SETTING UP A SKIN BANK Dr. Sunil Keswani Cosmetic ,Burn Surgeon, & Medical Director, National Burns Centre.
  2. 2. ORGAN DONATION  Most popular organ donation in terms of life-saving is blood and hence most meaningful  Eye donation is fast becoming popular, and one is aware of the possibility to donate eyes after death  Kidneys and liver are donated as well but this is less common due to complexities involved  The next achievable organ donation will be human skin. Hence the concept of SKIN BANK 2
  3. 3. SKIN BANKING THE PURPOSE BEHIND…
  4. 4. SKIN BANKING:  Skin banking is a facility where the skin is collected from eligible deceased donor and processed as per international protocols.  Skin can be stored in the skin bank at 4- 80 Celsius up to 5 years.
  5. 5. THE RATIONALITY OF THE PROJECT:  In case of extensive burns, the protective barrier- skin is burnt.  Leading to infection, in most cases becomes fatal.  Patients can be saved if we have enough skin in Skin bank.
  6. 6. MAGNITUDE OF THE PROBLEM  The estimated annual burn incidence in India is approximately 6-7 million per year.  Nearly 1 to 1.5 lac people get crippled and require multiple surgeries and prolonged rehabilitation  Seventy percent of the burn victims are in most productive age group of 15 to 40 years .  most of the patients belong to poor socioeconomic strata.  Source: Indian J Plast Surg. 2010 September; 43(Suppl): S6–S10.
  7. 7. NEED OF SKIN BANK  Lesser hospital stay.  Cost of treatment goes down.  Reduced pain.  Increased survival rate.  Results in less scarring
  8. 8. WHY DOES ONE NEED DONATED SKIN AFTER MAJOR BURN??
  9. 9. SKIN  The body’s first line of defense  Is water proof and prevents infection from entering the body  When severely damaged, the defense mechanism breaks down  If untreated, bacterial infection, dehydration, loss of protein and electrolytes takes place  Ultimately the victim dies National Burns Centre 9
  10. 10. SKIN National Burns Centre 10
  11. 11. KINDS OF BURNS Dry Burns – Flame Scald Burns National Burns Centre 11 Thermal Burns
  12. 12. KINDS OF BURNS (CONTD.) National Burns Centre 12 Chemical Burns – Acid, Alkali Electrical Burns – Electrical Spark and Electrical Shock Radiation Burns – Nuclear, Sunburn, X-Rays
  13. 13. THERMAL BURN PARTIAL AND FULL THICKNESS National Burns Centre smkeswani@gmail 13
  14. 14. CADAVERIC SKIN HARVESTING  Most preferred donor skin  Only the superficial layers of the skin are harvested from thighs and back  No disfigurement  No bleeding  No matching is required  Can be harvested in 45 minutes  Should be harvested within 6 hours after death National Burns Centre 14
  15. 15. EXCEPTIONS: People expired due to:  HIV and HBsAg negative  Skin disease  Cancer  Jaundice  Sexually transmitted disease  Severe infection National Burns Centre 15
  16. 16. PHASES OF SKIN BANKING ESTABLISHMENT 1. SETTING UP THE NECESSARY INFRASTRUCTURES AND EQUIPMENTS. 2. RECRUITING MANPOWER. 3. CREATING AWARENESS ABOUT SKIN DONATION. 4. RETRIEVAL. 5. PROCESSING. 6. STORAGE. 7. QUALITY MANAGEMENT SYSTEM FOR CONSISTENT QUALITY. 8. MEDICAL DOCUMENTATION.
  17. 17. Sr. No. Description Approximate cost (INR) Use 1 Furniture &Fixtures 3,00,000 For skin banking facility 2 Bio safety cabinet 3,00,000 For skin processing. 3 Skin Donation Vehicle 5,00,000 For Transportation. Cold Room 4,50,000 For skin storage 5 Sealer 5,000 For Sealing the Bag. 6 Mesher 3,50,000 For Meshing the Skin. 7 Shaking Incubator 1,70,000 For shacking the Skin at particular Temperature. 8 Dermatome 5,50,000 For Harvesting the Skin. 9 Walk in Fridge 5,00,000 For Storing the Skin. 10 Computer & Accessories 75,000 For storing data 11 A/C 75,000 Skin bank processing room and Office Total Cost 27,75,000 INFRASTRUCTURE COST
  18. 18. INFRASTRUCTURE Changing Room 50sq.feet Skin Processing Room 400sq.feet Skin storing Cold Room (Outer View) 100sq.feet (Administrative office 300sq.feet)
  19. 19. EQUIPMENTS Shaking incubator Biosafety cabinet Hot air oven Sealer
  20. 20. DERMATOME USED FOR SKIN HARVESTING
  21. 21. FULL VIEW OF DERMATOME
  22. 22. PERSONNEL COSTING Fixed personnel Skin Processing Team 2 members- (preferably biotechnologist/microbiologist) Work-  Skin processing  Skin donation kit preparation  Documentation  Quality management .  Overall management of skin bank  Salary-Aprox. (Rs15,000x2)p/m Floating personnel Skin Donation team- (Existing staff of the hospital) Team consisting of 4 members 1Team leader - Doctor/trained technician. 3 Assisting members.- nurses/paramedics. The skin bank has to be in an hospital set -up so as to have enough trained manpower for attending skin donation call 24x7 round the year. The average cost per call cost about Rs.5000 (Includes Consumables, transport and incentives to the team )
  23. 23. RETRIEVAL  Clean body with Betadine Skin Harvesting with the help of Dermatome Dressing body after harvesting Skin Ready for harvesting
  24. 24. Skin Processing Trimming the skin sample SKIN PROCESSING AT SKIN BANK
  25. 25. SKIN PROCESSING-PHASE III
  26. 26. LABELLING AND PRESERVATION
  27. 27. MEDICAL DOCUMENTATION  Donor registration verification.  Serological investigation verification after death.  Documentation of different phase of skin processing in skin bank .  Documentation of recipient name and hospital and Doctor concerned.  Record of rejected skin during the processing if the any serological finding ,microbiological test report are awaited . National Burns Centre smkeswani@gmail 27
  28. 28. OUR EXPERIENCE WITH SKIN DONATION OVER LAST FOUR YEARS IN MUMBAI Year Number of Donation Number of Awareness Program Conducted 2010 15 35 2011 54 60 2012- 2013 88 191 126 156
  29. 29. 0 50 100 150 200 250 YEAR 2010 YEAR2011 YEAR 2012 YEAR 2013 YEAR WISE STATISTICS OF SKIN DONATIONS
  30. 30. 0 5 10 15 20 25 30 YEAR 2010 YEAR 2011 YEAR 2012 YEAR 2013 COMPARATIVE DATA OF NO. SKIN DONATIONS IN LAST 4 YEARS
  31. 31. •Awareness by using newspapers, Magazines and journals •Conducting lectures in school, colleges and institutes. •Community Awareness Programme for Skin Donation. •With the help of NGO’s. •By organizing Seminars on Skin Donation. •Awareness by promoting the burns victims to share their trauma in front of the public (Burn survivor community). AWARENESS social worker conducting school education programme Students attending seminar on Skin donation
  32. 32. STANDEES TO BE PUT ON DISPLAY IN HOSPITALS AND MALLS
  33. 33. AWARENESS MATERIALS
  34. 34. PLEDGE FORM TO BE KEPT AT PUBLIC PLACES Outer View Inner View Kangaroo Pouch
  35. 35. Pledge Form to be filled and returned to National burns Centre Magnetic Sticker to be displayed on Fridge as reminder Cards for the kangaroo pouch for the Pledge Form Pocket Card for the skin donor
  36. 36. … spread awareness Write ups / Articles in Magazines, Bulletins, Newspapers, Journals, and Social Media
  37. 37. … spread awareness Hoardings including public transport like BEST Buses, Auto rickshaws, trains, etc…
  38. 38. … spread awareness • Conduct lectures in schools, colleges, institutes • Seminars for general practitioners, general public
  39. 39. … spread awareness Call the HOD & TC. of the Hospital you are affiliated with to the seminar
  40. 40. … spread awareness Include Skin Donation Awareness during other community programs in urban and rural areas
  41. 41. … spread awareness Art or talent competition with theme as Skin, Eye, Organ Donation
  42. 42. NAME OF STUDENT- HARESH JAIPRAKASH DHANU NAME OF COLLEGE- L S RAHEJA SCHOOL OF ARTS 1ST PRIZE WINNER
  43. 43. NAME OF STUDENT- CHINAMYEE MUKADAM NAME OF COLLEGE- RACHANA SANSAD COLLEGE OF APPLIED ART AND CRAFT 2ND PRIZE WINNER
  44. 44. NAME OF STUDENT- BHAVEN D FURIA NAME OF COLLEGE- L S RAHEJA SCHOOL OF ARTS Joint 3rd PRIZE WINNER
  45. 45. CONCLUSION  Half of the burn patients who are dying now can be saved if more skin banks are established in the country to collect more skin for covering extensive burn wound after early excision.  Early removal of dead skin and homografting will lead to quicker healing with less scar.
  46. 46. Thank You

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