Tissue Bank, Dr Stanisław Sakiel Centre for Burn Treatment, ul. Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland.
University of Barcelona, Barcelona, Spain.
Cell Tissue Bank. 2022 Dec;23(4):863-885. doi: 10.1007/s10561-022-10001-z. Epub 2022 Mar 30.
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.
烧伤是一种突发伤害,如果不及时治疗,可能会对患者的生命造成威胁。大规模灾害事件可能会涉及大量严重烧伤的患者。这类患者通常只有有限的健康、未烧伤的皮肤区域,可以从中采集自体断层皮片。在这种临床情况下,有必要使用特定的皮肤替代物。在治疗这类患者时,非活性同种异体人类皮肤移植物材料可能被认为是最合适的皮肤替代物。目前,波兰没有足够的同种异体人类皮肤移植物材料供应,无法满足突发和意外的大规模灾害所带来的需求。本研究涉及对选定的大规模灾害的分析。由此,根据已核实的伤亡概况,对所需的最小库存同种异体人类皮肤移植物材料进行了估计。由于皮肤供体数量不足,导致皮肤量不足,而这又源于当前的组织捐献系统。因此,提出了组织、法律和系统变革的建议,以改善波兰移植学的状况,特别强调皮肤捐献。为了实现战略库存的人类皮肤移植物,应组织一个组织收集移植团队。应扩大非医师移植团队成员的权利和义务。还提出了宣传活动(广告、海报等)和教育计划(教育视频、移植协调员培训期间的讲座等)的建议。最后,还提出了处理同种异体皮肤库存物流管理的可能方法的建议。在大规模灾害中,估计需要 60 万平方厘米的必要的基本库存同种异体人类皮肤。