Skin Bank shines a ray of hope to burn patients

At least 4,500 sq cm of skin have been deposited at the Skin Bank as of Monday, collected from the bodies of seven donors

The first ever ''Skin Bank'' in Bangladesh has opened at the National Institute of Burn and Plastic Surgery in Dhaka, where the skin is collected from donors and used for transplantation on patients with burn injuries.

Set up with technical assistance from the Singapore General Hospital, or SGH, it was inaugurated on Jan 9.

Currently, eight doctors and nurses are working at the Skin Bank.

All of them have been trained at the SGH.

After opening, the Skin Bank collected at least 4,500 sq cm of skin from the bodies of seven donors, as of Monday.

Also, a skin transplant was done on the bodies of three burn patients.

All of those patients were in good condition, said the doctors at the burn institute

Globally, the first skin bank was established in the US in 1939, according to Sciencedirect, a website that publishes medical research papers.

It was set up by the US Navy.

Europe had its first skin bank established in 1952, at University Hospital Hradec Králové in the Czech Republic. In India, such a bank was established 20 years ago.

WHO CAN DONATE SKIN, HOW TO PRESERVE IT

Physicians at the Skin Bank said plastic surgeons collect the skin from the donors. Then it is transferred to the Skin Bank in a special container. Within 24 to 48 hours it goes through a process called 'rinsing,' which means cleaning its blood and fat with a chemical and keeping it in a biosafety cabinet.

After cleaning, the skin is kept in the refrigerator at a temperature of 2 to 8 degrees Celsius, dipping it in an antibiotic solution. In the meantime, the collected skin undergoes a 'culture' or a laboratory process to see if it has any bacteria or viruses in it.

Once it is confirmed to contain no harmful element, the skin is dipped into liquid nitrogen and stored in the freezer at minus 90 degrees Celsius. This can be stored for five years.

Whenever a patient needs to undergo skin transplantation, the Skin Bank can provide it.

It is carried in a temperature-controlled special container at that time also.

Skin Bank coordinator Associate Prof Mahbub Hasan told bdnews24.com: "We're still not ready to collect skin from donors immediately after their death. The skin removed for patients' bodies during surgeries are now stored at the bank. As of now, seven donors have donated their skin."

"Many people undergo surgery to treat their obesity. In such cases, flesh from the lower abdomen is removed. It is called 'abdominoplasty' in medical terms. Each patient throws out 400 to 500 square cm of skin for the surgery."

"This skin has no use for the patient. Our plastic surgeons keep that extra skin. Later, we collect it and store it in the Skin Bank," he said.

Mahbub said they were pondering about collecting skin from those who donate their bodies after death for medical research purposes.

In that case, a large amount of skin can be gathered at once.

Amatullah Ummul Wara, a doctor working at a private hospital, has donated skin to the Skin Bank.

Ummul Wara underwent surgeries twice during giving birth, she told bdnews24.com.

Also, she had a hernia operation as well.

Hence, her tummy became bigger and she had an "abdominoplasty" as suggested by her doctor.

“This wasn’t an endeavour to enhance beauty, but the surgery was done on a medical ground. To do the surgery, a chunk of my skin had to be thrown out. My doctor wanted to know if I would like to throw away the excess skin or donate it to the Skin Bank. I said without any hesitation that I wanted to donate.”

Savar’s Baroipara resident 8-year-old Mariam has been admitted to the National Institute of Burn and Plastic Surgery for two months after suffering burn injuries.

She had a skin transplantation done.

Mariam’s mother Ms Mozema said she caught fire when trying to warm herself by going near the gas stove during winter.

“Sirs (doctors) transplanted a donor’s skin from the Skin Bank on her. It suited her and now she’s in a better condition,” said Senior Staff Nurse Monira Sultana.

BENEFIT OF SKIN BANK

The National Institute of Burn and Plastic Surgery, established eight years ago, is an institute bearing international standards, its physicians say.

However, they could not provide their patients with the service of skin transplantation as there was no skin bank.

Shawon Bin Rahman, resident physician at the institute, told bdnews24.com: Burn injuries are considered as ‘major burn’ if a patient has burn injuries on 35 to 50 percent of their body. They can have skin transplantation done if their health condition is good.

“If we can provide the skin, there’s a fair chance for that patient to survive. Thus, we can decrease the death toll (from burn injuries).”

He said that after having burn injuries, a patient has their veins exposed. All types of fluid including albumin, electrolytes flow out of the body. This leads the patient towards septicemia and LDS, which can be fatal, he said.

“If we can cover this with skin, the patient loses less fluid and their physical complications reduce.”

Shawon Bin Rahman said that it was hard to conduct skin transplantation on a patient having burns on more than 50 percent of their body. With burn injuries on 50 percent of the body, the patient does not remain in a position where doctors can administer anaesthesia on them.

According to the Directorate General of Health Services, as many as 12,811 people sought medical treatment at the National Institute of Burn and Plastic Surgery from January to November last year.

At least 4,480 of them were admitted to the institute and 1,002 of the admitted patients died.

[Writing in English by Sabrina Karim Murshed]