Skin donation still a tough sell

Only 2 donors last year; most mistakenly believe it means disfigurement

PEOPLE shy away from the thought of donating the skin of a loved one who has died. Consequently, there were only two donors to the National Skin Bank last year.
One was a three-month-old boy, Ryan Wong, who died from complications following surgery for a cleft lip.His parents, Mr Norman Wong, 47, and his wife Juliet, 38, donated his skin, as his other organs were too small to be viable. The identity of the other donor last year is unknown.

There is one donor so far this year: Triad leader Tan Chor Jin, 41, better known as 'One-eyed Dragon', who was hanged in January. He had asked for his skin, cornea and kidneys to be given away.

The shortage in skin donations is a long-standing issue, said Associate Professor Colin Song, director of Singapore's biggest burns unit, at the Singapore General Hospital (SGH).
A sizeable bank is needed to cope with accidents such as the one which occurred on Feb 27, when five workers suffered chemical burns from an acid spill at Chemic Industries in Tuas. Four have died.

Skin, the largest organ in the human body, is not covered under the 22-year-old Human Organ Transplant Act, so hospital staff have to ask the deceased's family to consent to a donation.
The answer is often 'no', primarily because people mistakenly believe donating a dead person's skin means disfigurement.

Prof Song, who also heads the department of plastic, reconstructive and aesthetic surgery at the hospital, said it was not the case. Only the outermost layer between 0.25mm and 0.4mm thick - thinner than a piece of facial tissue paper - is taken from flat surfaces like the thighs and back. These are concealed by clothing and will not mar the donor's appearance.
Up to 2,000 sq cm of skin - about the size of a page of this newspaper - can be harvested from those areas in an adult.
To be prepared for a crisis, such as a national fire disaster, the SGH Skin Bank needs 60,000 sq cm of skin - or skin from 30 adult donors. It has that amount now, but Prof Song said it could do with more such donations.

Singapore has had to import skin from Australia, the United States and the Netherlands, at $200 for a piece about the size of an adult's palm. In 2007, only one donation was made and, between 2004 and 2006, no more than two to four each year.
Prof Song explained that donations are rare also because people do not know how useful donated skin is. It is used as a temporary dressing in cases of severe burns of 40 per cent of the body and higher, to reduce the growth of bacteria and loss of the patient's vital fluids. It is usually discarded in three weeks. By then, new skin which has been cultivated from the patient's own cells would have grown enough to be used as a replacement.
Burn victims with less than 40 per cent burns can use their own skin for grafts, usually harvested from the thighs.

An example was Yio Chu Kang MP Seng Han Thong, who suffered about 15 per cent burns to his face, arms and chest. He had a graft using skin from his inner thighs.
To create public awareness, the SGH Burns Centre and the Burns Support Group are organising a public forum later this year to discuss skin donation.
And since 2006, the SGH Skin Bank, together with the National Organ Transplant Unit, has gone to junior colleges and polytechnics to tell students about the importance of organ and tissue donation.

The SGH Burns Centre treats about 300 burn patients a year. About 15 per cent of them have major burns, with between 30 and 40 per cent of the surface of their body burnt.

By Judith tan