The cost-effectiveness of maintaining an in-house glycerol-preserved skin bank

Ying, Yeo Siek; Hamzan, Muhammad Izzuddin; Sulaiman, Wan Azman Wan; Halim, Ahmad Sukari

doi:10.1016/j.burns.2021.05.001

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…This is done for at least 30–60 min. [ 58 ] If the glycerol is not removed and the skin has open wounds, it may result in high systemic concentrations. This may lead to myonecrosis at high doses.…”

Section: Resultsmentioning

confidence: 99%

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Glycerolised skin allografts for extensive burns in low- and middle-income countries

Iyun

Ademola

Olawoye

et al. 2021

J West Afr Coll Surg

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Introduction: There has been a significant improvement in the outcome of treatment of large surface area burns in developed countries. A major contributory factor is an early excision and skin grafting of burn wounds. The initial coverage of large surface area deep burn wounds requires the use of temporary skin substitutes such as allografts due to limited skin autografts. Cadaveric skin allografts are the commonest source of skin allografts in use; however, there may be religious, cultural, cost, or other factors mitigating its availability and routine use in low- and middle-income countries (LMICs). Human skin allografts may be used fresh or stored in tissue banks to ensure its ready availability. The purpose of this review is to promote glycerolised skin allografts as a means of skin preservation in low-resource countries above other modalities cryopreservation due to its cost advantages and relative ease of operation. Materials and Methods: A literature search for articles related to human skin allograft use in burn care, skin banks, and glycerolised skin allografts in LMICs was done using PubMed, EMBASE, and Web of Science databases. The key words used were ‘allograft’ and ‘burn’ with a filter in the search for human studies. The relevant references in the articles obtained were also searched for and included in the review Results: Sixty-three journal articles were reviewed for contents in line with the objectives of this study. Conclusion: Glycerolised skin graft is a viable option for coverage of extensive burns in LMICs.

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Section: Resultsmentioning

confidence: 99%

“…The estimated cost of 1 cm2 of GPA in a skin bank is $0.55,[ 63 ] whereas in the Euro Skin Bank, it is €0.91. [ 58 ] This makes it a favourable option of preservation in LMICs.…”

Section: Resultsmentioning

confidence: 99%

Glycerolised skin allografts for extensive burns in low- and middle-income countries

Iyun

Ademola

Olawoye

et al. 2021

J West Afr Coll Surg

View full text Add to dashboard Cite

show abstract

“…For the storage of tissue, there is also the option of freezing the skin with liquid-phase nitrogen, called cryopreservation. However processing skin with glycerol is simpler, more cost-effective and additionally has antimicrobial and antiviral properties [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

A single-stage bilayered skin reconstruction using Glyaderm® as an acellular dermal regeneration template results in improved scar quality: an intra-individual randomized controlled trial

et al. 2023

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Background Absence of almost the entire reticular dermal layer is inherent to the use of autologous split-thickness skin grafting (STSG) to close full-thickness wounds, often resulting in hypertrophic scars and contractures. Many dermal substitutes have been developed, but unfortunately most have varying results in terms of cosmetic and/or functional improvement as well as patient satisfaction, in addition to high costs. Bilayered skin reconstruction using the human-derived glycerolized acellular dermis (Glyaderm®) has been reported to result in significantly improved scar quality using a two-step procedure. Unlike the necessary two-step procedure for most commercially available dermal substitutes, in this study we aimed to investigate the use of Glyaderm® in a more cost-effective single-stage engrafting. This is a method which, if autografts are available, is preferred by the majority of surgeons given the reduction in costs, hospitalization time and infection rate. Methods A prospective, randomized, controlled, intra-individual, single-blinded study was performed, investigating the simultaneous application of Glyaderm® and STSG vs. STSG alone in full-thickness burns or comparable deep skin defects. During the acute phase, bacterial load, graft take and time to wound closure were assessed and were the primary outcomes. Aesthetic and functional results (secondary outcomes) were evaluated at 3, 6, 9 and 12 months follow-up using subjective and objective scar measurement tools. Biopsies for histological analysis were taken at 3 and 12 months. Results A total of 66 patients representing 82 wound comparisons were included. Graft take (>95%), pain management and healing time were comparable in both groups. At 1 year follow-up, the overall Patient and Observer Scar Assessment Scale assessed by the patient was significantly in favour of sites where Glyaderm® was used. Not infrequently, patients attributed this difference to improved skin sensation. Histological analysis showed the presence of a well-formed neodermis, with donor elastin present for up to 12 months. Conclusions A single-stage bilayered reconstruction with Glyaderm® and STSG results in optimal graft take without loss of Glyaderm® nor the overlaying autografts due to infection. The presence of elastin in the neodermis was demonstrated during long-term follow-up in all but one patient, which is a crucial factor contributing to the significantly improved overall scar quality as evaluated by the blinded patients. Trial registration The trial was registered on clinicaltrials.gov and received the following registration code: NCT01033604.

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Morphological Post-implantation Features of Aortic Conduits After Long-term wet Storage

et al. 2023

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The cost-effectiveness of maintaining an in-house glycerol-preserved skin bank

Cited by 3 publications

References 10 publications

Glycerolised skin allografts for extensive burns in low- and middle-income countries

Glycerolised skin allografts for extensive burns in low- and middle-income countries

A single-stage bilayered skin reconstruction using Glyaderm® as an acellular dermal regeneration template results in improved scar quality: an intra-individual randomized controlled trial

Morphological Post-implantation Features of Aortic Conduits After Long-term wet Storage

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