An Expert Tells You Everything About Skin Transplant
Currently, "burns" are a critical and significant global public health issue.As indicated by WHO report in 2014, a bigger fraction of people is affected by burn wounds than those from malaria and tuberculosis. Approximately 1, 80, 000 casualties are reported with burn injuries each year with the maximum number from the low and centre pay nations.
Treatment and consequences of burn wounds
The treatment requires immediate hospitalisation with intensive consideration and various restorative medical procedures, prompting very high morbidity and monetary hardships for the person in question. With the widespread headways in the medicinal innovation, more emergency clinics are setting up burn units, thereby, bringing down the death and handicap rate caused by burn wounds. Burn wounds that cause physical harm, however, can likewise leave a psychosocial and financial impact on the patient. The patient must learn to live not only with lasting deformation but also with the trauma following the incident.
Medically, the skin is a barrier against all external particles, including viruses, and bacteria. Therefore, damage to the skin, especially damage as severe as serious burns, weakens this defensive barrier, lowering the body’s immunity.
Skin donation: Procedure and advantages
In India, more than 7 million individuals experience the ill effects of burns or wounds each year after mishaps. As indicated by insights, around 80% of these are women and children, of which 10% develop perilous conditions as an outcome of damaged organs; and around half of them succumb to their wounds. Therefore, it can be stated that skin donation is the only solution for a burn patient.
The skin that is harvested from the deceased donor is stored in the skin bank and used for the treatment of burn victims. The damaged portion of the skin is replaced with the healthy harvested skin. However, this is an impermanent biological dressing, particularly when the necessity of skin coverage is huge and not accessible from the patient's own body. It counteracts disease and reduces the loss of liquids and protein, hence, improving the patient's condition. If not treated immediately, there is a high risk of infection, fluid loss, and in severe cases, it might also cause death. The use of donated skin has reduced the number of surgeries and thus reduced morbidity and cost of treatment.
The strategy of skin transplant incorporates collecting skin samples from both the legs, thighs, and the back. The reaping or harvesting of skin is done by the collection team comprising of a doctor, a nurse and an attendant. The harvesting of the skin takes a mere 30-40 minutes, but the whole procedure, including harvesting, bandaging, and cleaning might take more than an hour. The donated skin is utilised for the treatment of patients with extreme burns, which aids in averting disease, quickening the way towards mending/recuperation and ultimately helps in saving a life. It may likewise be used during outrageous instances of tissue loss, for example- in cases of diabetic foot.
The procedure of skin reaping incorporates cleaning of skin with 1% povidone-iodine, 70% liquor, and clean saline. Every single surgical equipment ought to be sterile to avoid any damage to the harvested skin. Skin of 0.4mm (0.01") thickness is cut by dermatome. Segments of skin are harvested from areas like back and inner thighs. Roughly 20-30% of the body-area skin can be collected from every donor.
Recently, there was a burn case where a patient from Varanasi got thermal burn damage at home while working, with approximately 62% burns. When the patient settled hemodynamically after the underlying treatment, she was taken for a medical procedure, which was 21 days after the day of incidence. The shallow and severely charred areas for the most part was mended in 3 weeks, and what remained after that was second degree profound and severe singeing.
An economical and unique way of using the harvested skin is ‘meshing’. Here, the skin harvested from the donor in the ratio of 1:1.5 makes 1 sq cm of skin-spread over 3 sq cm. region. Thus, less skin can cover more area.
The concept of skin donation is not one that is new. Established in 1950, the first skin bank was opened in the USA. However, when it comes to skin donation, there is a lack of public awareness. This is on account of misconceptions about the process of donation, causing further discouragement among people who want to donate skin.
Dr Vispi Jokhi is Consultant Orthopaedic Surgeon and the CEO of Masina Hospital. He is also a Health Council Member at Healthhunt.