September 25, 2021 6:43:00 pm
Government hospitals in Bengaluru are ill-equipped to treat severe burn injuries since they lack adequate reserve of skin graft required for reconstructive procedures.
The lone skin bank at the state government-run Victoria Hospital has just 4,500 sq cm of skin graft left which, at best, might suffice for two patients. While skin reconstruction is free of cost at Victoria Hospital, the prices can be exorbitant at private hospitals.
Dr Ramesh KT, Head of the Plastic Surgery Department at Bangalore Medical College and Research Institute (BMCRI), told The Indian Express that the skin bank has seen no activity in the last one year owing to the pandemic.
“The situation is improving but there is very little awareness about skin donation. Treatment costs are high at private hospitals and patients who come to our hospital are not always from affluent families. The treatment is free in our hospital but we do not have enough skin grafts. The requirement is huge. If there is a major burn case, we need 5,000 sq cm of skin,” he said.
“We closed the bank during the pandemic. Two months ago, we received four donations. Every month we receive a minimum of seven to eight requests, but we do not have that much reserve. People think that donating skin would disfigure the body, but the truth is that only the outer layer of the skin from thighs and legs (maximum 1,500 sq cm) is taken,” said Nagaraj BN, who is in charge of the skin bank at BMCRI.
A recent blast at a godown in Bengaluru left two people dead and several others with burn injuries. According to Dr Ramesh, the injured persons had sustained 30 per cent burns for which skin transplant is not required.
Cadaver skin is also used as a temporary covering over a burn wound. It can be stored at sub-zero temperature for up to five years. The skin has to be harvested within six hours of a death and the process takes around 30 minutes.
According to Dr Gunasekar Vuppalapati, Senior Consultant Plastic Surgeon at GVG Invivo Hospital, if skin supplies are in surplus then cadaver skin can be used even for burns less than 40 per cent to relieve pain and facilitate recovery.
“Cadaver skin, however, can’t be used immediately after procurement. It takes two months to process donated skin before it becomes ready for use,” he said.
“The reserve at skin banks helps us decide whether we use it for all burn patients or exclusively for those with extensive burns. Right now, we can use it only for patients who suffer more than 40 per cent burns to prevent water loss, electrolyte loss, heat loss, protein loss and infection and to improve their chances of survival,” Dr Vuppalapati said.
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