The urgent need to achieve an optimal strategic stock of human allogeneic skin graft materials in case of a mass disaster in Poland

Abstract

A burn is a sudden injury which immediate or long-term consequences may be life-threatening for the patient. A mass disaster event may involve large numbers of severely burned patients. Patients of this type typically have a limited area of healthy, unburned skin from which an autologous split thickness skin graft could be collected. In a clinical situation of this type, it is necessary to use a particular skin substitute. Non-viable allogeneic human skin graft materials might be considered as the most suitable skin substitutes in the treatment of such patients. At present, Poland does not have a sufficient supply of human allogeneic skin graft materials to meet the needs arising from a sudden and unforeseen mass disaster. This study involved an analysis of selected mass disasters. From this an estimate was made from a verified casualty profile of the necessary minimum stock of human allogeneic skin graft materials. An insufficient amount of skin results from an inadequate number of skin donors, which in turn results from the current tissue donation system. Therefore, a proposal has been made for the organizational, legal and systemic changes required to improve the situation in Polish transplantology, with particular emphasis on skin donation. In order to achieve a strategic stock of human skin grafts, a tissue collecting transplantation team should be organized. The rights and obligations of the non-physician transplant team member should be extended. Proposals have been made for awareness campaigns (adverts, posters etc.) and educational schemes (educational video, lectures during transplant coordinator training, etc.). Finally, a proposal has been made for possible methods to deal with the logistic management of the allogeneic skin stock. The required, essential stock of human allogeneic skin in the event of a mass disaster has been estimated at 600,000 cm 2 . Supplementary Information The online version contains supplementary material available at 10.1007/s10561-022-10001-z.

A Survey of 1000 Respondents on the Polish Population’s Knowledge and Attitudes about Tissue/Organ Donation and Transplantation in Times of Allogeneic Tissue Shortage

“…Human allogeneic skin grafts retrieved from a deceased donor play an important role in the therapy of extensive and deeply burned patients [ 1 ]. The importance of grafts increases dramatically in the case of casualties of a fire mass catastrophe [ 2 ]. However, the effectiveness of human allogeneic skin grafts is limited by the availability of tissue material retrieved from deceased donors.…”

“…However, the effectiveness of human allogeneic skin grafts is limited by the availability of tissue material retrieved from deceased donors. The most important problem to be solved in transplantology is the shortage of donors and thus the shortage of organs and tissues in relation to the number of potential recipients [ 2 , 3 ]. On the other hand, a serious dissonance between the number of multiorgan donations and tissue donations can be seen [ 3 ] which worsens when the skin is taken into consideration [ 2 ].…”

“…The most important problem to be solved in transplantology is the shortage of donors and thus the shortage of organs and tissues in relation to the number of potential recipients [ 2 , 3 ]. On the other hand, a serious dissonance between the number of multiorgan donations and tissue donations can be seen [ 3 ] which worsens when the skin is taken into consideration [ 2 ]. Despite the many reports suggesting that the level of awareness about donation and transplantation is satisfactory [ 4 , 5 , 6 ] the level of actual organ retrievals often remains unsatisfactory [ 4 ].…”

“…There are therefore two procurement teams that collect allogeneic skin and, what is more, their range is locally limited. In this approach, there are proposals for systemic solutions which could lead to a central bank of allogeneic skin establishment in the event of a mass disaster (including war) [ 2 ]. However, at present, a frequently observed situation is retrieval of tissues/organs from a deceased donor during which, for example, corneas are retrieved, and the skin is not.…”

“…However, at present, a frequently observed situation is retrieval of tissues/organs from a deceased donor during which, for example, corneas are retrieved, and the skin is not. It should be remarked that the number of corneal retrievals was 744 while skin donation was 54 in 2020 [ 2 , 7 ]. The high number of corneal retrievals may be due to the fact that corneas are procured by more centers and additionally in forensic and funeral homes.…”