Hyderabad: Nearly four years after it was set up, the demand at Telangana’s only skin bank at Osmania General Hospital (OGH) surpasses the supply.
While plastic surgeons say that the bank ideally requires at least 10 harvests of skin every month, it has seen only 20 cadaver donations come their way since its inception in June 2021. While it has benefited about 40 individuals — all of them burn injury patients — surgeons maintain that the demand has jumped manifold over the years, making requirements of cadaver donors (brain dead and natural death individuals), in turn, much higher.
“We receive around three to four admissions for burn injuries every day (at least 90-100 in a month) of which 50% are children. Around 30% cases of the total are those with above 70% burns. While we have already used 10 harvests, the remaining 10 (size of around a few thousands sq cm) are being used for treatments presently,” said P Lakshmi, head of department (plastic surgery and burns), OGH. She added: “Harvesting the skin of an individual generates about 1,000 to 1,500 sq cm of skin and can be used to treat four children.”
The skin bank is equipped with a storage capacity of 1,000 harvests of skin for up to five years. Telangana govt’s Jeevandan programme also facilitates the skin donations for the bank.
Challenges
But there are challenges. Primary issue: Hesitation among family members.
Stating that the request of receipients always stay three to four times more than the number of donations, Dr Bhanu Chandra, senior transplant coordinator for Jeevandan, told TOI that while the family members agree for organ donation, they get surprised when informed about skin donation. “There is hesitation due to fear of disfigurement of the donor’s body and its external appearance after dressing. But it is a myth as only midline insertion is done, hence removing the outer layer of skin from the thighs and legs. Hence, during grief counselling, we first talk about organ donations, explain about its importance and subsequently talk about skin donation.”
Monetary backing
Dr Chandra noted that the donations have gone up every year since the opening of the skin bank, adding that, however, the demand for more harvests still outstrips the supply, “This is why it is necessary to secure more cadavers.” Additionally, Dr Lakshmi suggested that improved monetary backing can lead to better efficiency of the long-term project. Presently the department has a staff of around 25 doctors, including PG students, who work in shifts round the clock in shifts.
“If CSR funds can be roped in, it can be utilised to build a separate team of technicians, who can go and harvest the skin of the donors from their locations. This will save time and create multiple productivity as, at times, the doctors are also occupied with regular patients.”
How it works
After the death of a donor, the team from the bank goes to harvest skin, which needs to be secured within six hours. Additionally, blood is also collected from donors to check for infections and diseases. Culture tests are also performed on skin to ensure it is free of infections, diseases, or microorganisms.
In skin transplantation, also known as skin graft, a piece of skin is grafted from one area of the body to the injured part through the auto-grafting procedure, except in children up to seven to eight years of age due to increased risks. Once auto-grafting is done, skin from the bank is transplanted over it.
“It is done with an instrument called a dermatome from the lower limbs or the back of the donor. The skin from the bank reduces the pain, prevents infection and increases the survival rate. It is a gain for patients due to non-requirement of blood group matching required in skin grafting. There is no need to take any type of drugs too after the surgery,” said Dr Lakshmi.
Case studies
An eight-year-old child was treated by the OGH plastic surgery team in 2024 with 37% deep flame burns on the lower limb. The whole recovery took around four months after he was given multiple blood transfusions, albumin infusion and lots of nutritious food. Around 10 to 12 surgeries were done to save the boy. The wounds were healed after grafting 1,046 sq cm of skin from the bank.
In another case, in 2025, a three-year-old girl was treated by the OGH team. She was suffering from burn injuries with a large raw area of right upper limb circumferential post burn injuries.
