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control of fluid loss. [4‑7] For these reasons, their use results collected included the extent of the burnt region and
in a significant reduction in hospital stay and mortality burn depth.
rates, and may generate cost savings. [4‑7]
According to the Brazilian skin donation protocol, the
In 1949, the first skin bank was established by the US Navy. steps are as follows: (1) Paraná State Transplantation
Since then, several other skin banks have been founded, Center calls about a potential donor, and the skin bank
mostly in the USA and Europe and often organized as staff goes to the donor site hospital; (2) a physical
multi‑tissue banks. In 2005, there were approximately examination of the donor is performed to assess the
54 active skin banks in the North America. Currently, quality of the skin area to be harvested; (3) the donor’s
[5]
there are four skin banks in Brazil, based in São Paulo, medical and family history are screened to elicit
Porto Alegre, Recife and Curitiba city. The latter is any history of (a) ingestion of toxic or illicit drugs;
[7]
the skin bank of the Evangelical University Hospital of (b) high‑risk sexual behavior, recent invasive procedures,
Curitiba (HUEC), which officially opened on June 17, 2013 malignancies, chronic diseases, death from an unknown
and the activity of which is the focus of this study. cause, infectious disease, immunocompromise and
surgical procedures occurring within the prior 12 months;
In 2013, the plastic surgery and burns service of the and (c) donor age, which is limited to between 14 years old
Evangelical Hospital in Curitiba located in Paraná state and 60 years old; (4) blood samples are collected from
provided medical attention to approximately 4,500 burn the donor 72 h prior to cessation of circulation, 12 h
victims of which at least 10% required hospitalization with after the cessation of blood flow if the body has been
the potential indication for skin use; this demonstrated kept at room temperature, or up to 24 h after the
the importance of establishing a skin bank within this cessation of blood flow if the body has been cooled
hospital. The objective of this study is to report the to 4 °C ± 2 °C. The tissues cannot be released for use
1st year experience of the Evangelical Hospital of Curitiba until final results have been obtained. When tests for
skin bank.
HIV and hepatitis C virus (HCV) are negative, further
testing is performed for RNA detection of HIV and HCV.
METHODS Mandatory serological donor screening is performed
to detect the following: (a) hepatitis B (hepatitis B
Retrospective epidemiological and statistical data were surface antigen and anti‑hepatitis B core), (b) anti‑HCV,
collected during the 1st year of operations, from June 2013 (c) HIV‑1 and HIV‑2 (HIV 1 and 2), (d) Chagas disease
to August 2014. The study was approved by the Research (anti‑Trypanosoma cruzi), (e) syphilis (one treponemic
Ethics Committee of the Evangelical Beneficent Society of or nontreponemic test), (f) human T‑lymphotropic
Curitiba, Brazil. virus type I (HTLV‑I) and HTLV‑II (anti‑HTLV I and II),

Collected information included two different tissue banking (g) toxoplasmosis (toxoplasma IgG and IgM), and
aspects. The first includes data on skin retrieval between (h) cytomegalovirus (IgG and anti‑IgM); (5) the donor is
June 27, 2013 and June 26, 2014 and the second data accepted once all laboratory tests have been confirmed
set corresponds to skin distribution and transplantation to be normal; (6) skin harvest is then performed
between August 28, 2013 and August 27, 2014. for a thickness of 0.4‑0.8 mm. The skin blade is
passed to the nurse who takes swab and inoculates
Data were obtained from analysis of the bank’s records it in thioglycolate broth, amid Sabouraud broth and
of cadaveric (multi‑organ/skin tissue) donation and trypticase soy broth (TSB) respectively, then the nurse
tissue distribution, including a review of the necessary dips the blade in 0.9% saline solution twice prior to
documentation on the cause of death and organ donation.
immersion in glass with glycerol 90%; and (7) the stored
Inclusion criteria were all medical records of donors skin is processed in a sterile laminar flow hood in 3
of harvested skin and all recipients who received grafts phases: Phase 1: skin is removed from the shipping bottle.
during the 1st year of the bank. There were no exclusion Then 2 fragments of 0.5 cm × 0.5 cm of each blade are
criteria. withdrawn for microbiological analysis. Each fragment
must be macerated and inoculated in thioglycolate broth,
The data collected concerning the deceased donors included: Sabouraud medium, TSB broth and blood culture bottle
age, gender, skin color, cause of death, thickness of retrieved for aerobic and anerobic germs. The skin blades are
skin tissue (mm), body region from which the skin was stored again in new bottles with glycerol 90% sterile; the
removed, number of generated skin batches, hospital vials with the skin in 90% glycerol are placed in water
where the skin retrieval occurred, date of skin retrieval, bath at 37 °C for 3 h, then removed from water bath
area (cm ) of retrieved skin, reason of skin discards when and stored in tissues not released refrigerator; Phase 2:
2
unfit for use and the number of benefited patients from if the first phase microbiological analysis is negative for
each donor.
any germs (waiting time: 15 days) the second phase is
As for the skin recipients, collected data included: age, performed like the first one; and Phase 3: if the second
gender, hospital where the allografts were used, donor to phase microbiological analysis is negative for any germs
recipient ratio, area of allografted skin (cm²), graft release (waiting time: 15 days) the third phase is performed
date, body region receiving the allografts and indication like previous phases with removal of excess of glycerol;
for allograft use. In burn victim recipients, additional data thereafter, the blades are placed in a sterile plastic bag

Plast Aesthet Res || Vol 2 || Issue 6 || Nov 12, 2015 327