Some procurers, however, may take deeper cuts of skin that are more disfiguring, and may expose muscles, fascia and other structures. They may later separate the skin into a thin layer for grafts for burn victims, and a layer of dermis to be used in procedures like breast reconstruction after mastectomy.
Since there are usually no recipients waiting for skin, as there may be for organs like kidneys, the sheets are usually wrapped in gauze, folded, packaged individually, labeled and frozen. Donated skin can be kept this way up to five years.
The frozen sheets are thawed in a warm bath of saline before use on a patient, when they are stapled, sutured or glued on, Dr. Shahrokhi said.
To treat a burn patient, the surgeon removes dead skin as soon as the patient is stabilized, in order to prevent life-threatening infections like sepsis.
But the donor skin graft that is applied is only a temporary patch; it will be rejected by the patient’s immune system within a matter of weeks. Still, it provides the protective function of healthy skin: closing the wound, protecting against infections and fluid loss, decreasing pain and promoting healing.
Ultimately, the donor skin, called an allograft, must be replaced with an autograft, skin taken from another part of the patient’s own body.
Human skin is expensive. A single square centimeter can cost a hospital about $2.82, depending on the source, according to Mag Tait, director of the Trauma Burn Laboratory at Michigan Medicine.