GRH skin bank struggling to get donors

Madurai: Tamil Nadu is one of the top states in organ donation in India, thanks to increased awareness and new initiatives like honouring brain-dead donors. However, skin donation, which provides life-saving treatment for those suffering from burn injuries, has been quite low due to fears and myths surrounding it.The skin bank functioning at Government Rajaji Hospital (GRH) in Madurai gets only around five to six donors a year. GRH dean Dr L Arul Sundaresh Kumar said an average 10-15 patients are treated annually through transplants from the skin donated and preserved at the skin bank. Doctors can retrieve 15-18 sheets of skin from a deceased donor."Only the outer epidermis and a part of the inner dermis layer of the skin is removed during donation. There is a wrong belief that removing skin will mean leaving organs out in the open or the structure of the cadaver may change. Once skin donation is done, the body is sutured and covered," explained Dr S Aram, Head of Department of Plastic Surgery, GRH. The neutralised skin retrieved is stored at sub-zero temperatures inside the skin bank facility.Autograft, wherein tissue graft from the same person is used for transplant, is preferred for burn injury patients with less than 40% burns. However, for those with 40-60% burns, healthy skin available on their own body is not enough to cover all the injured portions. "Unlike other organ transplants which may need matching of blood type and other factors, there is no such restriction for skin transplants. The skin has to be free of infections only," said Dr Aram. Skin transplants help patients with 40-60% burn injuries who may also suffer from shock and other internal or external injuries. "Skin transplant is not permanent because it is a highly allergenic organ and the recipient's body will eventually reject it. Its benefit lies in providing life-saving cover in some of the more severe burn injury cases," added the doctor.Meanwhile, health activists fear that a dip in skin donations and transplantations at GRH will only help private hospitals. "The skin bank at GRH was established only after a PIL was taken up in Madras high court. Hospital authorities must take steps to form a dedicated counselling team to create awareness on skin donation, and have more deceased donors come forward," said C Anand Raj, an activist.At GRH, a specialised burns ward provides comprehensive care to patients. "Patients coming with firecracker injuries have come down due to better hospital facilities in Virudhunagar itself, but we have a lot of emergency cases of those attempting self-immolation. A psychiatrist is also called in to attend to the patient if needed," said Dr Aram.