The document discusses skin banking, which involves collecting skin from eligible donors, processing it according to international standards, and storing it at 4-8°C for up to 3 years. Skin grafts from skin banks can help save lives of burn patients by acting as a protective barrier and reducing infection rates. India has a high incidence of burns but limited skin banking facilities. The concept of skin banking originated in India and the first bank was established in 1972. Skin is collected, processed under sterile conditions, and stored using techniques to maintain viability for transplantation. Strict protocols are followed to screen for infections.

1. SKIN BANKING
DR SAMIK SHARMA

2.  Skin banking is a facility where the skin is
collected from eligible donor,processed as
per international protocols and stored in the
skin bank at 4-80 Celsius up to 3years.

3. 
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In case of extensive burns, the protective
barrier- skin is burnt.
Leading to infection, in most cases it
becomes fatal.
Patients can be saved if we have enough
skin in Skin bank.

4.  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
.

5. 
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Acts as the most effective dressing.
Acts as a barrier to infection & the rate of
infection is reduced significantly.
Lesser hospital stay.
Cost of treatment goes
down. Reduced pain.
Increased survival rate.

6. 

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Burns >30% BSA Adult
Burns >10% BSA
Children Deep Burns
Chemical
Burns
Electrical
Burns
Radiation
Burns

7. 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.

8. ORIGIN OF SKIN BANK CONCEPT
• Skin autografting was first described by Reverdin in 1871
• Girdner was the first to report the use of allogeneic skin to cover a
burn wound; however, it wasn’t until 5 years later that Thiersch
described the histologic anatomy of skin engraftment and later
popularized the clinical use of split-thickness skin grafts.
• Banking of human skin did not begin until the early 1900s. Wentscher
reported the transplantation of human skin that had been
refrigerated for 3 to 14 days.

9. • Bettman reported its success in the treatment of children with
extensive full-thickness injuries.
• Webster (1944) [8] and Matthews (1945) described the successful
take of skin autografts stored for 3 weeks at 4·C to 7·C
• 1949 that the United States Navy Tissue Bank was established,
signaling the beginning of modern day skin banking.
• Bondoc and Burke are credited with establishing the first functional
skin bank in 1971.

10. 
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The concept of Skin Bank was originated in
India by Late Dr.Manohar
H. Keswani out of dire need to save patients
with critical burns who were dying because of
lack of HOMOGRAFT .
In 1972, first skin bank was established at Wadia children's
hospital in Mumbai by Dr. Manohar H Keswani,which was
1stof its kind in India.
Exactly 35 yrs later in 2007, second skin bank in Mumbai
was established at National Burn Centre.
ORIGIN OF SKIN BANK CONCEPT IN INDIA

11. Changing Room Skin Processing Room
Cold Room (Outer View)
Cold Room (Inner View)

12. Shaking incubator
Biosafety cabinet
Hot air oven
Sealer
Centrifuge

13. COLLECTION OF BLOOD SAMPLE FOR
FOLLOWING TESTS
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HIV
HBsA
g
HCV
VDRL

14. SKIN DONAR DEFERRAL

15. 
Body is cleaned with Betadine scrub
Skin Harvesting with the
help of Dermatome
Body is dressed after harvesting
Liquid paraffin is applied

16. Skin Processing
85% glycerol is added to skin sample skin is stored at 4-80 Celcius
Trimming the skin sample

17. tion
• Donor registration and verification.
• Serological investigation and verifica
after death.
• Documentation of different phases of
skin processing in the skin bank.
• Documentation of recipient names,
hospitals and doctors concerned.
• Record of rejected skin during
processing in case any serological
or microbiological test report
is positive .
DOCUMENTATION

18. SKIN BANKS AND COLLECTION CENTRES IN
INDIA (16)

21. Clinical uses of allograft skin

23. Potential disadvantages of allograft use

24. SKIN DONAR DEFERRAL

25. SKIN PROCESSING
• Processing environment
• Skin is processed under aseptic conditions.
• Current AATB Standards indicate the need for processing in a class
10,000 laminar flow environment
• Microbiologic testing
• recommended is 1 cm2 biopsy sample be taken for each 10% of the
body surface area from which the skin has been removed.

26. • Allograft skin should not be used for transplantation if it contains any
of the following:
• (1) Coagulase-positive Staphylococci,
• (2) Group A, beta-hemolytic Streptococci,
• (3) Enterococci,
• (4) Gram-negative organisms,
• (5) Clostridia sp.,
• (6) yeast or fungi.

27. • Maintenance of viability
• Maintenance of cell viability and structural integrity are key to the
engraftment and neovascularization of allograft skin.
• Postmortem time lapse appears to have the single greatest effect on
skin viability.
• functional metabolic activity of the skin rapidly declines if the donor
is not refrigerated within 18 hours of death .

28. • Ideal nutrient tissue culture medium has not yet been identified
• Minimal Essential Medium (MEM)
• RPMI-1640
• University of Wisconsin solution
• Glycerol (10–20%) and dimethylsulfoxide (10–15%) widely used in
skin preservation.

29. • For heart-beating multiorgan donors, skin is procured after
circulation has ceased.
• Non-heart-beating donor skin can be harvested until 24 h after death
if the body is refrigerated or cooled within 12 h of death
• If the body is not cooled nor refrigerated, skin procurement must be
carried out within 15 h of death.
• Skin layers that are 400–800 µm thick are cut from the posterior
trunk and the lower limbs by battery-operated dermatome

30. • Skin allografts are placed in sealed sterile containers filled with a
specific transport medium supplemented with a combination of
antibiotics, according to validated skin bank protocols.

31. Storage methods
• Two common methods of skin allograft preservation are
• glycero-preservation
• cryopreservation.
• The main difference between the two techniques lies in tissue
viability:
• glycerolized and lyophilized skin grafts are not viable but retain structural and
mechanical properties
• whereas cell viability is maintained by cryopreserved, and to a lesser degree
deep frozen, skin grafts, so the tissue can be grafted onto a wound bed after
a certain period of time

40. •THANK YOU