MADURAI: The incomplete construction of the new burns unit building at Government Rajaji Hospital (GRH) has prolonged South Tamil Nadu's wait for a skin bank.
Nearly four years ago, the hospital had applied seeking the state government's nod for setting up a skin bank. The inspection and sanction which was kept in pending for long were expedited after the necessity for a skin bank at the hospital arose during Kurangani forest fire incident in March 2018.
Also, GRH receives victims of grievous burn injuries from firecracker and matchbox units at Sivakasi and Sattur in Virudhunagar district where fire accidents occur now and then.
According to the Transplant Authority of Tamil Nadu (TRANSTAN) website, only four hospitals in Tamil Nadu including one government hospital are equipped with skin banks. They are Government Stanley Medical College and Hospital in Chennai, Rights Hospital in Chennai, SRM Institutes for Medical Science in Chennai and Ganga Medical Centre and Hospital at Coimbatore. Notably, in January 2018, a biomaterial centre that also houses a skin bank was unveiled at the Government Kilpauk Medical College Hospital.
A similar biomaterial centre which will store skin, bones, tendons and ligaments, cardiac valves and other body tissues (at an estimated cost of Rs 80 lakh - Rs 1 crore) was on the cards at the government medical college hospitals in Madurai and Tirunelveli two years ago.
On August 8, 2018, GRH became the first hospital in South Tamil Nadu to receive a nod for skin bank. The state government's approval is valid for five years till 2023, subject to renewal. Two-and-a-half years have gone by since the hospital obtained approval, yet the skin bank remains elusive and the wait only seems to get longer.
According to hospital sources, a couple of months before Covid outbreak, a temporary site was earmarked in the hospital to set up the skin bank and the plan was dropped due to the pandemic. Following the inauguration of the new burns unit that was built at a cost of Rs 2.17 crore, it was decided that the skin bank would be housed at the building, as per the initial construction layout. As the incomplete portion in the first floor of the new burns ward includes the skin bank, it is unlikely that it would see the light of the day anytime soon.
What is a skin bank?
When skin is damaged, it either heals on its own or needs donor skin or a graft. The grafted skin provides comfort and prevents fluid loss and infection. Donated skin is a boon to patients with burns.
This skin is used as a biological dressing and as a temporary skin cover for patients with a higher degree of burns, acute skin failure due to drug allergies, degloving injuries, ulcers and acute slicing injuries. It also helps prevent infections and it falls off naturally within a couple of weeks after it is grafted on the recipient.
In the absence of a skin bank at hospitals, burn patients are usually treated using membranes of bovine collagen (a form of protein derived from cows) which costs around Rs 1,500 - Rs 2,000 per piece
Skin Bank functions
Retrieval Processing
Storage
Distribution
Medical Documentation
Process involved
* Anyone can donate skin irrespective of their blood group
* Skin can be donated within 6 hours from the time of death
* Skin of persons suffering from AIDS, Hepatitis B and C, sexually transmitted diseases, skin cancer, active skin disease and septicemia are considered unfit for donation.
* Skin is harvested from both the legs, both the thighs and the back.
* There are a total of 8 layers of skin and only one layer namely the uppermost layer of the skin is harvested.
* After the skin is harvested, the skin will be evaluated, processed, screened at the skin bank, and then supplied to the burns surgeon for transplanting on burn patients.
* The skin is preserved in 85 per cent glycerol solution.
* The harvested skin can be stored up to five years, at a temperature between 4 to 8 degree Celsius.