With insufficient availability of skin for grafting, two major skin banks in Mumbai are struggling to treat burn injury patients, adding to their suffering.
Reason for unavailability of skin is dip in its donations, lack of awareness and misconception. In 2016, 104 skin donations were reported, which is less by 58 than donations received in 2015.
Resident of Govandi, 11-year-old Afsa Shaikh (name changed) had suffered from 70 per cent burns on her hands, neck area and right leg in an autorickshaw fire accident in 2016. She is under treatment at Lokmanya Tilak Municipal General (Sion) Hospital, but is desperately waiting for skin.
“We are treating her for the last six months. Grafting has been done on her neck and hands. We are waiting for skin from last one week, so as to complete grafting procedure on her right leg,” said Dr Merlyn Matchavel, first-year resident doctor in surgery department at Sion Hospital.
“My daughter is soul of our family. Our house used to feel alive and happy when she used to smile, but after the fire accident, our house has become lifeless,” says mother of 11 year old burn patient Afsa Shaikh.
Skin donation data given by Sion Hospital shows fluctuation in number of skin donations made since 2013.
In 2016, there were 104 skin donations, which was less by 58 than donations made in 2015. In 2013, there were 148 skin donations, but these numbers saw a dip in 2014 with only 81 skin donations. Till January, 11 skin donations have been registered with Sion Hospital.
Describing the current scenario of skin donation at hospital, Matchavel said it is the lack of awareness among people, which is leading to unstable donation numbers every year and lack of skin for grafting of burn injury patients.
“We get one call in every three days for skin donation, but if the donor is suffering from Hepatitis B & C, AIDS or any kind of skin disease, then they are unsuitable for donation. We can’t take such skin as it can put life of burn patient at risk. Most donors we receive are from older group and we need young donors. This can only happen through awareness,” said Matchavel.
On an average, Sion Hospital receives 35 to 40 burn patients every month.
“There are many like Shaikh, who require skin to heal their burn injuries, but shortage of skin worsens their suffering,” added Matchavel.
Navi Mumbai’s National Burns Centre (NBC), a specialised centre of burns treatment and rehabilitation, has received 907 skin donations in last seven years.
During 2015 to 2016, NBC has received 219 skin donations, but the number of burn patients seeking treatment is three times more than donations.
Dr Sunil Keswani, Medical Director, NBC, explained why skin donation is important and why there is an urgent need to raise awareness about it.
“Skin is the primary protective barrier of body. In case of any burn injury, it is necessary to cover that area with some skin substitute. Failing to do this could lead to infection, fluid loss and ultimately, death,” said Keswani.
He said skin is best substitute for skin and cadaveric skin is best and cheapest substitute. This skin works as a temporary dressing, which helps in patient’s own skin to regenerate.
“Burn patients with over 40% to 50% injury need substitute skin and 80% of such patients can be saved if there are enough skin donations,” added Keswani.
Many city-based doctors also emphasise on raising skin donation awareness as it can play a vital role to save many lives.
Dr Anil Tibrewala, Consultant Plastic Surgeon at Hinduja and Breach Candy Hospital, pointed out that misconception among people deter them from donating skin.
“In many cases, donor’s family members discourage skin donation because they think that donation will disfigure the body, which is not true. But, this is the biggest hurdle, which can be reduced with strong awareness campaigns. Only 1/8th layer is harvested from legs, thighs and back of a dead person. So, there is no bleeding or disfigurement to the body,” added Tibrewala.
Dr Suhas Abhaynkar, Consultant Plastic Cosmetic and Burn Surgeon at Masina Hospital, feels multiple skin donation centres and teams should be set-up in the city.
“We desperately need to spread awareness about skin donation. As far as availability of skin is concerned, we should have multiple teams at different locations so that skin is donated on time. Six to eight hours is the ideal time for skin collection,” said Abhaynkar.