Skin transplant

Content

Introduction

Introduction

The skin transplant (epidermis or dermis) is technically considered a graft: a part of the skin (skin) of a donor is completely detached from its site of origin and used to cover the area of ​​another person called "recipient ".

When the donor and the recipient of the skin tissue are the same person, the graft is called autologous; we talk about homologous grafts if taken from a donor belonging to the same species as the recipient or from heterologous grafts if taken from a donor of a different species.

The autologous grafts they are able to take root completely; while in homologous grafts and - to a lesser extent - in heterologous ones, the dermis (deepest part of the skin) can take root more easily while the epidermis (most superficial part of the skin) has a greater risk of being rejected.

When transplant is needed

When transplant is needed

Skin transplantation may be needed in several conditions which include:

  • severe and extensive burns,in these cases it is a life-saving therapy
  • large ulcers, with the possibility of integrating the homologous dermis
  • epidermolysis bullosa
  • small burns, in delicate areas such as the face or hands
  • large ulcers
  • Lyell's syndrome
  • gangrenous pyoderma
  • decubitus
  • post-traumatic wounds, such as scalp tearing, amputations, etc.
  • losses of non-dermatological substances, such as perforation of the nasal septum, reconstructions of the soft parts of the mouth (stomatologic), reconstructive surgery and post-oncologic plastic, sometimes necessary after surgery to remove tumors
Tissue origin: cadaver donation

Tissue origin: cadaver donation

The skin (skin) is taken from dead donors; the removed skin layer is thin (about 400-800 microns thick) and usually belongs to non-visible areas.

Skin tissue cannot be removed from donors who have died of tumors, ongoing infections and degenerative diseases of the central nervous system.

After careful checks (screening) of the donor, the collection is carried out in the operating room by trained medical personnel.

You can become a skin donor at virtually any age.

The tissue banks

The tissue banks

Once collected, the skin (skin tissue) is placed in sterile, refrigerated containers and is sent to the skin bank, structure where the fabrics are treated and stored.

In Italy there are 5 authorized leather banks, all public and located in:

  • Milan
  • Turin
  • Verona
  • Cesena
  • Siena

The skin can be cryopreserved, cryofrozen (with maintenance of cell viability at various degrees) or glycerolized. That is, the skin, depending on the use for which it is intended, is preserved, after specific processing, with different methods and temperatures in order to maintain its qualitative characteristics.

At the banks of the skin are also preserved the so-called dermal matrices, that is, the dermis deprived of the epidermis (de-epidermized dermis - DED or dermis) or even of the cells (decellularized). The dermal matrices can be used as a guide structure (scaffold) or in the reconstruction of leaks of dermal substance or in general and post-oncological surgery.

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