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Burn Victims Said in Line for Donors

April 18, 2000

SANTA ANA, Calif. (AP) _ Burn victims waiting for potentially life-saving skin donations often find themselves in line behind people signed up for cosmetic surgery, according to a newspaper report.

Federal regulations ensure that kidneys, hearts and other internal organs go to patients in greatest need, but skin is not covered by law. Much donated skin is used for procedures that could wait, such as erasing laugh lines, enlarging sex organs or supporting bladders, The Orange County Register reported Monday in an examination of profits made from donated body parts.

``It’s a big moral dilemma for tissue banks,″ said Judy Perkins, a member of the Skin Council of the American Association of Tissue Banks who runs the University of San Diego Tissue Bank. ``Anyone who is supporting a burn unit like I am, you can’t fathom why you wouldn’t take skin for burn victims first.″

Of 139 burn centers nationwide, 11 have their own skin banks. Other burn centers must pay whatever price tissue banks are charging.

LifeCell Corp. of New Jersey has about 20 tissue banks regularly providing skin, which the company uses to produce AlloDerm, a product originally developed to help reconstruct burn victims’ skin.

LifeCell now estimates potential revenue from AlloDerm in reconstructive and cosmetic surgeries at $200 million annually, 10 times what the company could hope to make assisting burn victims.

``The burn market is clearly less attractive,″ LifeCell President Paul Thomas said. ``With plastic (surgery), it’s just a much bigger marketplace, a bigger opportunity and better reimbursement.″

University Hospital in Newark, N.J., called six tissue banks looking for skin to cover burns suffered by Dana Christmas, a 21-year-old student burned in a January dorm fire that killed three people at Seton Hall University. She had burns over 60 percent of her body.

The hospital finally found just enough skin at a tissue bank in San Diego.

Musculoskeletal Transplant Foundation, a tissue bank 20 minutes from Christmas’ hospital room, could not help because all its donated skin is committed to Collagenesis Inc. of Massachusetts, which markets a new product for plastic surgery. Foundation President Bruce Stroever said the tissue bank doesn’t even process skin for burns.

``It shocks me,″ said Jonathan Walker, the hospital’s materials manager. ``A hospital should have first choice, and then they can take care of the companies. It should go in order of importance.″

In February, skin was in such short supply at the Grossman Burn Center in Sherman Oaks that doctors had to stretch skin grafts beyond their normal size to cover Benancio Lopez, severely burned in an industrial accident.

At Grossman Burn Center in Anaheim, staff called more than 15 banks for a burn victim last November but had to leave some burned areas open because they could not find enough skin, said nurse Jeannette Ochs. The patient died of complications from the burns.

Life Alaska in Anchorage used to send its skin to the Intermountain Tissue Center in Salt Lake City, which prepares skin for burn centers. It now sends all of its skin to LifeCell, partly because the company pays twice as much.

``I’d like to say that the price didn’t enter into it, but it was a factor,″ said director Jens Saakvitne.

Jennifer Borders of Lake Forest has lived both sides of the issue, undergoing breast-reduction surgery but also having a 5-year-old daughter who required skin grafts for a burned hand.

``My body’s not perfect, either. If I could drop six grand and redo my lips or my nose, I might do it,″ Borders said. ``But at the same time, if you’re going to be using skin, emergencies should come first.″

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