Skin donation in Tamilnadu.

Tamil Nadu may lead the country in cadaver organ donation, but it lags behind, sadly, in skin donation, with donors reluctant to part with the organ.

The concept of skin donation, popular in the northern states, is yet to take off here. Since the inception of the organ donation programme in Tamil Nadu in 2008, only one skin donation has been made. On Monday, World Plastic Surgery Day, some city-based doctors made a call for creating more awareness about skin donation so that many burns victims would benefit.

Skin grafting is the only option to reconstruct badly burnt body parts of fire accident victims. In most cases, doctors say, donated skin can be used as a temporary solution to reduce infections. “Even if people are hesitant to donate the skin of their departed loved ones, because of the way the body will look like once the skin has been removed for transplant, the skin on the back, thighs and stomach can always be given. But cultural stigma continues to discourage people from donating skin,” said Prof Jagan Mohan, chief of the burns ward at the Kilpauk Medical College and Hospital (KMCH).

Raw skin takes a minimum of 14-21 days to heal and donated skin would give temporary cover for a week at least. “The body will eventually reject the donated skin. But until the new skin grows we can use the donated skin to buy time,” he said.

While hospitals like KMCH get around 7-10 burns cases in a day, at least half are third degree burn injuries. “Usually we use autologous grafting in which the patient’s skin from the thighs is taken. But it leaves a patch in the part of the body from where the skin is taken, making it vulnerable to infections. This patch can be covered using the donated skin as a temporary cover until new skin grows.” says Prof Jayaraman, senior reconstruction surgeon and former head of the KMCH burns unit. A skin bank would be of great help, as nothing can replace the functioning of natural human skin, he added.

In the case of minor burns there is an expensive option of using biodegradable collagens, a laboratory-generated tissue, to hasten the healing process. “But for severe burns collagens would not help. Human skin is the only option,” said Prof Jayaraman.

Apart from educating the public about skin donation, plastic surgeons should come forward and demand cadaver skin so that doctors can persuade the relatives and make sure patients benefit, said Dr Amalorpavanathan, state organ transplant co-ordinator.

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