Without skin donors, burn patients at two Bengaluru hospitals are left to suffer

Two medical facilities in the city treating burns patients are struggling to heal them without skin donations, which is affected badly due to the raging pandemic.

Mahabodhi Burns Centre inside Victoria Hospital and the six-bedded burns ward in St John’s Hospital witness a severe shortage of skin.

Doctors noted that they could do skin grafting by taking the patient’s own skin from the unaffected part of the body, but acknowledge that it would only add to the injury, compound the pain and, in some cases, directly affect the patient’s recovery.

In pre-pandemic days, hospitals would ask skin to be harvested from dead people, but the Covid-19 outbreak has severely hurt donations.

St John’s depends on Mumbai’s National Burns Centre for cadaver skin. In life-threatening situations, the hospital takes the skin from the patient’s relatives. Skin is taken from the thighs and back of the live donors, who are left to cope with pain for two weeks.

“There are no cadaver skin donation due to Covid,” admitted Dr K T Ramesh, Professor & Head of Department, Plastic Surgery, Bangalore Medical College and Research Institute (BMCRI), who also heads the Mahabodhi Burns Centre.

“Storage (of skin) at our institute has also depleted. We are left with 3,000 cm of skin adequate to treat just one patient. Since the lockdown, we have had just one donor,” Dr Ramesh added.

While the Mahabodhi Burns Centre was admitting 150 patients a month before the pandemic, the numbers have dropped to 70 now. Though cadaver skin is good to use, doctors now have no choice, but to excise the wounds, regularly dress the burnt area and use the patient’s own skin for grafting — the process known as autografting.

“This is the only option we have for reconstruction,” Dr Ramesh said. “(Autografting) can’t be an option if the patient has 40% or 50% burns.”

Patients have their wounds covered with the donated skin for three to four weeks, which allows the burnt area to heal. This also makes management simpler.

“Now, though they continue to suffer. Their chances of survival improve with donor skin,” Dr Ramesh said.

St John’s faces a similar crisis. "If Mahabodhi's skin bank doesn't have skin, we get it from Mumbai's National Burns Centre,” said Dr Vijay Joseph, Professor of Plastic Surgery at the hospital.

“Ever since skin came under the Organ Transplant Act, we have stopped using live donor skin except in life-threatening situations when they come forward to save life. We used live donor skin for 20 years, but we stopped it in 2014. If we can’t procure it from Mumbai, we give relatives the option to donate after due process and consent.”