Safdarjung Hospital’s skin bank up and running

A total of 14 skin donations were received by Safdarjung Hospital in the national capital over the past five months since the Human Skin Bank unit became functional in January 2024, according to a senior doctor at the facility.

Speaking to Patriot, Dr Sujata Sarabahi, Head of the Department of Burns, Plastic, and Maxillofacial Surgery at Safdarjung Hospital, said, “The hospital has performed a total of five successful skin transplants in the five months. Out of the total 14 donations, nine samples are undergoing sterilization, which takes nearly 45 days. Following this, the skin is ready for transplant.”

Inauguration and functionality 

The Human Skin Bank at Safdarjung Hospital was inaugurated in 2023 and became functional in January 2024. 

“We only take donations from the deceased or brain-dead. We need to take the skin within six hours following the patient’s death due to the high temperatures in the country. After that, the skin starts to decompose,” said Dr Sujata. 

“However, if the body is stored in a cold environment, the skin can be taken within 16 to 20 hours of death,” she said.

Informing about the process after taking the skin, Dr Sujata said, “The Skin Bank at Safdarjung Hospital in New Delhi provides critical support to burn victims and patients requiring skin grafts. Established to address the urgent need for skin donations and grafts, the bank follows a comprehensive process to ensure the safe and effective handling of donated skin.”

Comprehensive Process 

“The journey begins with the identification and recruitment of potential donors. Safdarjung Hospital collaborates with organ procurement organisations and other medical institutions to find suitable skin donors. Consent is obtained from the donor or their family, adhering strictly to ethical and legal guidelines,” informed Dr Sujata, who is also the president-elect for the National Academy of Burns of India (NABI). 

“Skin is usually harvested within a short time-frame after the donor’s death, typically within 24 hours, to ensure the tissue remains viable. This skin is then transported to the Skin Bank under controlled, sterile conditions.”

Upon arrival, the donated skin undergoes thorough screening and testing to rule out any infectious diseases and contaminants. Blood samples from the donor are tested for pathogens such as HIV, hepatitis B and C, and syphilis.

“Following these tests, the skin is meticulously processed, which involves cleaning to remove blood and debris and treating it with antimicrobial agents to reduce infection risk. The skin may also be trimmed into standardised sizes for easier application in medical procedures,” she explained.

The processed skin is preserved using advanced techniques like cryopreservation or glycerol preservation.

“Cryopreserved skin is stored in liquid nitrogen at temperatures below -196°C, while glycerol-preserved skin is kept at refrigerated temperatures around 4°C. To maintain the integrity of the preserved skin, regular quality control checks are performed. These checks include periodic microbial testing and continuous monitoring of storage conditions,” she stated.

“When a request for skin grafts is received, the Skin Bank prepares and ships the required amount of skin to the requesting medical facility. Proper documentation and tracking ensure the traceability of the skin from donor to recipient, maintaining transparency and accountability. At the medical facility, the preserved skin is thawed (if cryopreserved) and prepared for transplantation. Surgeons apply the skin grafts to the patient, often as a temporary covering to protect wounds and promote healing until the patient’s own skin regenerates or a permanent graft can be applied,” she said.

Benefits, challenges, and future

“The Skin Bank maintains detailed records of all donations, processing, and distributions. Follow-up with the medical facilities ensures the proper use of skin and allows monitoring of any adverse reactions. By adhering to stringent protocols and guidelines, the Skin Bank at Safdarjung Hospital ensures safe, effective, and ethical handling of donated skin, significantly aiding patients in need of skin grafts and supporting the broader medical community in treating severe burns and other skin injuries,” she added.

Also Read: Delhi: Safdarjung Hospital to plant 500 trees to fight climate change

She said that the skin transplant is not permanent. 

“We apply the treated skin for only three weeks on the patient to provide temporary relief from excruciating pain. After that, we remove the skin from the patient’s wound surface as the new skin replaces it by that time. It is a very beneficial practice for burn patients,” Dr Sujata said. 

“The good thing about this transplant is that the patient does not need any post-treatment medications for their body to adapt to it,” she said.

The criteria for accepting skin donations are that the deceased person should be above 18 years, and the skin of a person up to 90 years old can be taken depending on its condition. 

“He/She should not have any skin-related diseases such as HIV, hepatitis B and C, and syphilis,” she noted.

When asked about how long the skin can be kept in storage for future use, she said the skin can be stored in cold storage for two to five years.

Dr Deepak Nanda, Professor, and Consultant at the Department of Burns, Plastic and Maxillofacial Surgery at Safdarjung Hospital, said, “There is a need to create awareness regarding skin donation among people as it is the largest organ of the body. Apart from this, in cases where the MLC (medico-legal cases) are ready to donate skin, the doctors need police permission, which delays the process. Doctors need support from law enforcement authorities as well. Additionally, we need more transplant coordinators to create more awareness regarding skin donation.”

India currently has 26 skin banks. These facilities, which collect and preserve donated cadaveric skin for use in treating burn victims, are distributed across several states. Maharashtra has the highest number with seven skin banks, followed by Tamil Nadu with four, Karnataka and Delhi with three. 

The three skin banks in the Capital are at the All India Institute Of Medical Sciences Delhi (AIIMS), Safdarjung Hospital, and RR Hospital.

India’s first skin bank was established in 1972 by Dr Manohar H Keswani at Wadia Children’s Hospital in Mumbai. This pioneering initiative marked a significant milestone in the medical field, addressing the critical need for skin grafts in burn treatment and other reconstructive surgeries.