Human skin processing affects clinical outcome in allograft recipients

Skin allografts represent a milestone in burn patient treatment. However, skin procurement is still burdened by high rates of contamination, and validation procedures have not yet been standardized. In addition, it is not clear if tissue viability affects allograft skin outcomes. In 2120 skin samples from 610 donors, a retrospective analysis was performed to identify donor and procurement variables associated with bacterial contamination and tissue viability. Post-processing contamination was associated significantly with the donor type, cause of death, length of hospitalization, procurement site, surgeon, interval between procurement and banking, and decontamination method. Tissue viability appeared to be negatively associated with freezing. In two series of skin allograft recipients (155 and 195 patients), we evaluated the role of skin characteristics and procurement variables on clinical outcomes. We found that the length of hospitalization was associated significantly with donor age. Procalcitonin and PCR values in allograft recipients were correlated with the decontamination method. No significant associations were observed between tissue viability and clinical outcomes (length of hospitalization, cause of donor death, or inflammatory parameters) after allograft transplantation. In these large case series, we identified donor and procurement variables that may affect allograft skin recipients. The decontamination method appeared to be a critical step for skin allograft requiring better standardization. (c) 2022 Elsevier Ltd and ISBI. All rights reserved.

Automated summary

Skin allografts in burn patient treatment face challenges of high contamination rates and lack of standardized procedures. The impact of tissue viability on allograft outcomes remains unclear. Retrospective analysis of skin samples revealed associations between contamination and variables such as donor type, cause of death, and decontamination method. Clinical outcomes in allograft recipients were influenced by donor age and decontamination method. Standardizing the decontamination process is critical for improving allograft skin transplantation.