TODAY’S TOPIC: Dutch Lab Preserves, Ships Human Skin For Burn Victims
BEVERWIJK, Netherlands (AP) _ The wealth on deposit at this Dutch coastal city’s most unusual bank sits in simple jars, each containing skin donated by the dead for recycling on the living.
The nine-year-old Dutch National Skin Bank processes about 50 donated bodies a year, using a method of preservation through glycerol immersion that it claims is inexpensive, long-lasting, and lends itself easily to transportation.
″We are the only skin bank in the world, as far as we know, currently using high concentrations of glycerol for skin preservation,″ claimed researcher Hans Hoekstra in an interview.
And he added that skin preserved by the bank’s method was not rejected by recipients’ bodies as quickly as skin preserved by other methods, notably freezing, freeze-drying and deep-freezing through immersion in liquid nitrogen.
Glycerol is a syrupy substance commonly used as a preservative in other skin banks, notably in the United States, but in such low concentrations that the skin must also be frozen to preserve it.
The Dutch bank’s procedure begins with the removal of superficial layers of skin, measuring 12-15 thousandths of an inch thick and up to two inches wide, from the legs and backs of donor bodies, using a specially designed electrically-operated shaver.
Standard organ transplant forms are required for the operation, which generally takes about two hours per body.
The donor skin must be shaved off within 12 hours of death and then treated with the glycerol, which replaces the tissue’s natural water content. The strips of skin are rolled and put in jars, which are then refrigerated.
″With this method you can keep the skin without changing its structure for at least 20 months,″ said Rudolf Hermans, a surgeon and burn specialist at the hospital and one of the skin bank’s founders.
One of the advantages of the Beverwijk method is that the preserved skin can be shipped without refrigeration, said Hoekstra, adding that ″you can put the skin in your own car and transport it anywhere in the world.″
The skin is ultimately used in combination with a burn victim’s own skin to prevent life-threatening infection and foster the growth of replacement tissue.
At the adjacent Red Cross Hospital in this coastal Dutch city, surgeons use the preserved skin in what is known as the ″double-coverage″ or ″sandwich technique.″
After the removal of burned skin, a small amount of the patient’s own skin, cut off and expanded by a special machine into a mesh pattern, is put over the burn area and covered by a sheet of the preserved donor skin.
As the burn victim’s own skin grows to cover the wound, the donor skin is gradually rejected and peels away.
Although no transplanted skin is ever permanently accepted by the body, Hermans claimed that skin preserved in the high concentration of glycerol resists rejection for four to six weeks, compared to only one to two weeks for skin preserved by other methods.
The skin bank, the only one in the Netherlands, supports itself through fees as well as private donations. It charges about $1.50 per square inch of skin, exclusive of transportation costs.
Last year, the bank provided a total of 48,000 square inches of donor skin to burn victims in the Netherlands, Belgium and Germany.
The bank currently has about 16,000 square inches of skin in storage, but, because of demand, has been recently providing hospitals with more skin than it takes in.
Last month, the bank sent five jars, containing a total of 4,000 square inches of skin, to Jerusalem’s Hadassah Medical Center for surgery on two Israeli soldiers severely burned in a suicide bomb attack in southern Lebanon.
Hoekstra said the bank’s primary mission is to meet Dutch demand; it only provides skin to foreign hospitals on an emergency basis.
In the case of Israel, ″we reacted to a call to save lives,″ Hermans said, referring to recent public criticism over sending skin to a nation involved in an armed conflict.
″It was a human, not a political decision,″ said Hermans.
He added that Israel’s request was an ″exceptional″ case, because Orthodox Jewish restrictions there forbid the removal of body organs from the dead unless they are used immediately to save life.