1. SETTING UP A SKIN BANK
Dr. Sunil Keswani
Cosmetic ,Burn Surgeon,
&
Medical Director,
National Burns Centre.

2. ORGAN DONATION
 Most popular organ donation in terms of life-saving
is blood and hence most meaningful
 Eye donation is fast becoming popular, and one is
aware of the possibility to donate eyes after death
 Kidneys and liver are donated as well but this is
less common due to complexities involved
 The next achievable organ donation will be
human skin. Hence the concept of SKIN BANK
2

3. SKIN BANKING
THE PURPOSE BEHIND…

4. SKIN BANKING:
 Skin banking is a facility where the skin
is collected from eligible deceased
donor and processed as per
international protocols.
 Skin can be stored in the skin bank at 4-
80 Celsius up to 5 years.

5. THE RATIONALITY OF THE PROJECT:
 In case of extensive burns, the protective
barrier- skin is burnt.
 Leading to infection, in most cases becomes
fatal.
 Patients can be saved if we have enough
skin in Skin bank.

6. MAGNITUDE OF THE PROBLEM
 The estimated annual burn incidence in India is
approximately 6-7 million per year.
 Nearly 1 to 1.5 lac people get crippled and require
multiple surgeries and prolonged rehabilitation
 Seventy percent of the burn victims are in most
productive age group of 15 to 40 years .
 most of the patients belong to poor socioeconomic
strata.
 Source: Indian J Plast Surg. 2010 September;
43(Suppl): S6–S10.

7. NEED OF SKIN BANK
 Lesser hospital stay.
 Cost of treatment goes down.
 Reduced pain.
 Increased survival rate.
 Results in less scarring

8. WHY DOES ONE NEED DONATED SKIN
AFTER MAJOR BURN??

9. SKIN
 The body’s first line of defense
 Is water proof and prevents infection from entering
the body
 When severely damaged, the defense mechanism
breaks down
 If untreated, bacterial infection, dehydration, loss of
protein and electrolytes takes place
 Ultimately the victim dies
National Burns Centre
9

10. SKIN
National Burns Centre
10

11. KINDS OF BURNS
Dry Burns – Flame Scald Burns
National Burns Centre
11
Thermal Burns

12. KINDS OF BURNS (CONTD.)
National Burns Centre
12
Chemical Burns
– Acid, Alkali
Electrical Burns –
Electrical Spark and
Electrical Shock
Radiation Burns – Nuclear,
Sunburn, X-Rays

13. THERMAL BURN PARTIAL AND FULL THICKNESS
National Burns Centre
smkeswani@gmail
13

14. CADAVERIC SKIN HARVESTING
 Most preferred donor skin
 Only the superficial layers of the skin are harvested
from thighs and back
 No disfigurement
 No bleeding
 No matching is required
 Can be harvested in 45 minutes
 Should be harvested within 6 hours after death
National Burns Centre
14

15. EXCEPTIONS:
People expired due to:
 HIV and HBsAg negative
 Skin disease
 Cancer
 Jaundice
 Sexually transmitted disease
 Severe infection
National Burns Centre
15

16. PHASES OF SKIN BANKING ESTABLISHMENT
1. SETTING UP THE NECESSARY
INFRASTRUCTURES AND EQUIPMENTS.
2. RECRUITING MANPOWER.
3. CREATING AWARENESS ABOUT SKIN
DONATION.
4. RETRIEVAL.
5. PROCESSING.
6. STORAGE.
7. QUALITY MANAGEMENT SYSTEM FOR
CONSISTENT QUALITY.
8. MEDICAL DOCUMENTATION.

17. Sr. No. Description Approximate cost
(INR)
Use
1 Furniture &Fixtures
3,00,000 For skin banking facility
2 Bio safety cabinet
3,00,000 For skin processing.
3 Skin Donation Vehicle
5,00,000 For Transportation.
Cold Room 4,50,000 For skin storage
5 Sealer
5,000 For Sealing the Bag.
6 Mesher
3,50,000 For Meshing the Skin.
7 Shaking Incubator
1,70,000 For shacking the Skin at
particular Temperature.
8 Dermatome
5,50,000 For Harvesting the Skin.
9 Walk in Fridge
5,00,000 For Storing the Skin.
10 Computer & Accessories
75,000 For storing data
11 A/C
75,000 Skin bank processing room and
Office
Total Cost 27,75,000
INFRASTRUCTURE COST

18. INFRASTRUCTURE
Changing Room 50sq.feet
Skin Processing Room 400sq.feet Skin storing Cold Room
(Outer View) 100sq.feet
(Administrative office 300sq.feet)

19. EQUIPMENTS
Shaking incubator
Biosafety cabinet Hot air oven
Sealer

20. DERMATOME USED FOR SKIN HARVESTING

21. FULL VIEW OF DERMATOME

22. PERSONNEL COSTING
Fixed personnel
Skin Processing Team
2 members-
(preferably
biotechnologist/microbiologist)
Work-
 Skin processing
 Skin donation kit preparation
 Documentation
 Quality management .
 Overall management of skin bank
 Salary-Aprox. (Rs15,000x2)p/m
Floating personnel
Skin Donation team-
(Existing staff of the hospital)
Team consisting of 4 members
1Team leader - Doctor/trained
technician.
3 Assisting members.-
nurses/paramedics.
The skin bank has to be in an hospital
set -up so as to have enough trained
manpower for attending skin donation
call 24x7 round the year.
The average cost per call cost about
Rs.5000
(Includes Consumables, transport and
incentives to the team )

23. RETRIEVAL

Clean body with
Betadine
Skin Harvesting with the
help of Dermatome
Dressing body after
harvesting
Skin Ready for harvesting

24. Skin Processing Trimming the skin sample
SKIN PROCESSING AT SKIN BANK

25. SKIN PROCESSING-PHASE III

26. LABELLING AND PRESERVATION

27. MEDICAL DOCUMENTATION
 Donor registration verification.
 Serological investigation verification after death.
 Documentation of different phase of skin processing in
skin bank .
 Documentation of recipient name and hospital and
Doctor concerned.
 Record of rejected skin during the processing if the any
serological finding ,microbiological test report are
awaited .
National Burns Centre
smkeswani@gmail
27

28. OUR EXPERIENCE WITH SKIN DONATION OVER LAST
FOUR YEARS IN MUMBAI
Year Number of Donation Number of
Awareness Program
Conducted
2010 15 35
2011 54 60
2012-
2013
88
191
126
156

29. 0
50
100
150
200
250
YEAR 2010 YEAR2011 YEAR 2012 YEAR 2013
YEAR WISE STATISTICS OF SKIN
DONATIONS

30. 0
5
10
15
20
25
30
YEAR 2010
YEAR 2011
YEAR 2012
YEAR 2013
COMPARATIVE DATA OF NO. SKIN DONATIONS
IN LAST 4 YEARS

31. •Awareness by using newspapers,
Magazines and journals
•Conducting lectures in school,
colleges and institutes.
•Community Awareness Programme
for Skin Donation.
•With the help of NGO’s.
•By organizing Seminars on
Skin Donation.
•Awareness by promoting the
burns victims to share their trauma
in front of the public (Burn survivor
community).
AWARENESS
social worker conducting school education programme
Students attending seminar on Skin donation

32. STANDEES TO BE PUT ON DISPLAY IN HOSPITALS AND MALLS

33. AWARENESS MATERIALS

34. PLEDGE FORM TO BE KEPT AT PUBLIC PLACES
Outer View Inner View
Kangaroo
Pouch

35. Pledge Form to be
filled and returned
to National burns
Centre
Magnetic Sticker to be
displayed on Fridge as
reminder
Cards for the kangaroo pouch for the Pledge Form
Pocket Card for the
skin donor

36. … spread awareness
Write ups / Articles in
Magazines, Bulletins,
Newspapers, Journals,
and Social Media

37. … spread awareness
Hoardings including public transport like
BEST Buses, Auto rickshaws, trains, etc…

38. … spread awareness
• Conduct lectures in schools, colleges, institutes
• Seminars for general practitioners, general public

39. … spread awareness
Call the HOD & TC. of the Hospital you
are affiliated with to the seminar

40. … spread awareness
Include Skin Donation Awareness during
other community programs in urban and
rural areas

41. … spread awareness
Art or talent competition with
theme as Skin, Eye, Organ
Donation

42. NAME OF STUDENT- HARESH JAIPRAKASH DHANU
NAME OF COLLEGE- L S RAHEJA SCHOOL OF ARTS
1ST PRIZE
WINNER

43. NAME OF STUDENT- CHINAMYEE MUKADAM
NAME OF COLLEGE- RACHANA SANSAD COLLEGE OF APPLIED
ART AND CRAFT
2ND PRIZE
WINNER

44. NAME OF STUDENT- BHAVEN D FURIA
NAME OF COLLEGE- L S RAHEJA SCHOOL
OF ARTS
Joint 3rd PRIZE
WINNER

45. CONCLUSION
 Half of the burn patients who are dying now
can be saved if more skin banks are
established in the country to collect more
skin for covering extensive burn wound after
early excision.
 Early removal of dead skin and homografting
will lead to quicker healing with less scar.

46. Thank You