Month: September 2017

Skin Donation and Skin Banking: FAQ

Skin Donation and Skin Banking: FAQ

The life is greatest gift of God. Extending life of one person has immense implications on the patient and his dependent family. It would be befitting to return the thanks if one could just help another person to enjoy this gift to the fullest, after one’s death.

Most people are aware of Kidneys, Liver, Heart, Eye donation but One more significant addition to this list is SKIN ! Donated Skin can be utilized for treating severely burnt patients.

Recently, Nagpur has got a Cadaveric Skin bank where this donated skin is processed and stored for use on burn patients.

Magnitude of the Burn injuries:

The estimated annual burn incidence in India is approximately 6-7 million per year. Majority of the extensively burnt patients die. These are the patient deficient of autograft (Donar skin from the same individual for grafting). Nearly 1 to 1.5 lack people get crippled and require multiple surgeries and prolonged rehabilitation. Seventy percent of the burn victims are in most productive age group of 15 to 40 years. The treatment cost is immense but unfortunately, most of the patients belong to poor socio-economic strata.

Now imagine all these patients getting benefit both treatment wise, and financially. That’s the impact donated Skin and Skin bank cause on these patients.

When a person can donation his skin?

A person can donate his skin within in 6 hours from his death. It can also be harvested from a brain dead patient.

Who can donate skin?

Anyone irrespective of sex & blood group, if he or she is above 18 years age.

How much time the whole Skin Donation procedure takes?

About 20 – 25 minutes.

Is it necessary to transport the donor to the hospital after death?

No, Skin Bank Team will come to the donor’s home, hospital or morgue wherever the donor is kept. We don’t need to shift the donor to the operating room, hospital or ambulance.

Who performs the Skin Harvesting procedure?

By Skin donation Team consisting of one Doctor, two Nurses and one attendant.

How the skin is harvested?

By using a special instrument called DERMATOME.

Is the consent for skin donation is taken before the skin harvesting procedure?

Yes, doctor will take consent of the next of kin of the donor and a witness

From which part of the body skin is harvested?

Skin is harvested from both the legs, both the thighs and the back.

Is entire thickness of the skin is harvested?

NO, only 1/8th layer i.e. the uppermost layer of the skin is harvested.

Is there any bleeding or disfigurement to the body?

No, there is no bleeding or disfigurement at the site of skin donation. After the procedure body parts are bandaged in a proper way.

What conditions render skin unfit for donation?

Skin of persons suffering from AIDS, Hepatitis B & C, Sexually Transmitted Diseases, Skin Cancer, Active Skin Disease & Septicemia.

What about diabetes & hypertension?

Even donors with these conditions can donate their skin.

How will my donation be used?

After the skin is harvested, skin will be evaluated, processed, screened at skin bank, and then supplied to the Burns Surgeon for transplanting on burn patients.

How do you preserve the skin & how long it can be preserved?

In 85% glycerol solution, it is stored between 4-5 degree Celsius and it can be stored for a period of 5 years.

Do we have to pay the Skin Donation Team?

No !Selling & buying organs is illegal.

Do we need to produce any documents to the Skin Bank Team when they arrive?

Yes, DEATH CERTIFICATE & medical records, if any.

Is there any kind of Donor-Recipient matching required for skin transplant?

No, any one’s skin can be transplanted on any one, no blood, colour or age matching required.

Is it compulsory to pledge or register ourselves with the skin bank if we wish to donate skin?

No, it’s not compulsory to pledge or register, but your relatives should know & consent for skin donation.

If we want to call your Skin Bank Team for a skin donation call what should we do?

You can call us on our 24 hours ROTARY OCHRI SKIN BANK, NAGPUR HELPLINE NUMBER 9422106298 or 0712- 6634800.

 

Guidelines for Donating Organs

Guidelines for Donating Organs

Organ transplantation is one of the greatest miracles of the last century. Transplantation would not be possible but for organ donation by fellow human beings magnanimity to share their organs. Organs can be donated while living or after death (Cardiac & Brain death). A living person can donate blood, bone marrow, one kidney, part of liver, etc. After cardiac death, only tissues can be donated such as eyes and skin within 6 hours of death. What is more important is after brain death (Deceased Organ Donor) a person can donate & save the lives of up to eight people by donating the heart, lungs, liver, kidneys, pancreas, and intestines, besides several tissues such as eyes, skin, bones, tendons, soft tissue, heart valves, veins, etc. The latter is a routine practice in the developed countries. In India, except barring few States DOD has not fared well till recently. With the formation of National Organ & Tissue Transplant Organization (NOTTO) recently the numbers are growing, yet we have a long way to go. Unawareness, religious misconceptions, and superstitions are the main reasons for this.

The Law: Transplant of Human Organs Act (THOA 1994 – Amendment 2011) governs organs and tissue donation & transplant activities. Organs cannot be sold nor purchased and is an offence.  Living organ donations is relatively easy if the donor is ‘first’ relation (parents, children, sibling, spouse, grandparents/children). Other relations and unrelated donors are scrutinized by a duly recognised Authorising Committee to rule out commercial dealings.

Understanding Brain-death: The term brain death is defined as “irreversible & permanent unconsciousness with complete loss of brain function”. Organ donations will take place only after certification of brain death by four certified experts by doing six mandatory tests done twice with a gap of six hours to be doubly sure that the patient is dead. This practice is accepted worldwide.

How does organ donation and transplant work?

Patients who require DOD transplantation have to register their names in the Hospital waiting list as well as Government regulated body called Zonal Transplant Coordination Centre (ZTCC). Health being a State matter, the patients from the State gets a priority. Whenever a DOD is reported to the ZTCC one kidney is utilsed by the Transplant Hospital and the second kidney goes to the patient registered  with the ZTCC according to the blood group and priority. As Nagpur is not carrying out only kidney transplantation, the Nagpur ZTCC informs the State Authority called State Organ and Tissue Transplant Organization (SOTTO), who distribute the organs such as liver, heart, lungs, etc to hospitals in the States (Mumbai, Pune, etc) according to the priority and approved practices. The recipient hospitals have to make arrangements to reach Nagpur earliest by commercial/chartered or air-ambulances. The retrieval of organs takes place when all the surgical teams reach the hospital where the DOD is present. After organs are retrieved, the organs are carried in special cold boxes by the respected teams to their hospitals. It is here that help from the Police is sought to create a ‘green corridor’ to facilitate moving the organs without any delay.

What should one do to donate organs?

The first thing to do is to sign a pledge after understanding the subject. One must discuss the matter with the family members so that they are aware of your decision. It is quite likely that the family members would also like to pledge. Anybody above 18 years of age can sign a pledge to donate organs. The forms can be obtained from the ZTCC, MOHAN Foundation Center, online from website of NOTTO, Mohan Foundation. You should keep the donor card with you, especially if you are travelling. A pledge card indicates the owners wish to donate organs. However (as per existing law) after the death, the family has to consent before the organs are donated. There are a few conditions (cancer, serious infection, etc) when donation cannot take place.

For further information contact: MOHAN Foundation. J-12, West High Court Road, Laxmi Nagar, Nagpur 440022. MS. E.mail: raviwankhede@mohanfoundation.org / 9423683350. Toll free Helpline 1800 103 7100   www.mohanfoundation.org

 

The Future of Refractive Surgery: Robotic and Nonsurgical?

The Future of Refractive Surgery: Robotic and Nonsurgical?

Refractive errors were being treated since last 25 years only. As of now LASIK is most frequently performed surgical procedure in entire medicine. Almost 6 million being performed yearly around the world with amazing rate of success.

Future of refractive surgery is great. 6/6 vision was considered to be the ultimate possible vision but it is being challenged and newer techniques are already offering better vision than glasses of 6/5, 6/4 by detecting and treating higher order aberrations of eye and cornea. Theoretically it’s possible to get much better vision  up to distance between two photo receptors of retina –  6/1  or better so that one will be able to read news paper from distance of six meters.

Presbyopia was ultimate paradigm to conquer in refractive treatments but corneal inlays, accommodative intraocular lenses, intracor femto laser procedures, cross linking and reversal of ageing natural lens by pharmacological medications  can postpone or reverse presbyopia to give youthful vision in coming future.

Development in intraocular lenses will change current absolute presbyopia to natural accommodative lenses. Any residual refractive errors can also be corrected by light adjustable lenses giving spectacle free vision to all.

Robotic surgeries are already being performed today for cataract by femto lasers assisted corneal incision, capsulotomy and lens division. Future diagnostic tools and lasers will be able to remove refractive errors and cataracts  with much precision and in no time.

Eye is accessible easily and optical properties of eye will make it a easy organ to make changes for artificial intelligence to diagnose and treat.

Refractive procedures almost always involve lasers or incisions, even at the most non-invasive levels. But a change is coming- A new procedure called PiXL (photorefractive intra stromal cross linking aims to use cross linking and UV light to alter corneal collagen and thereby cause a refractive change. It’s the kind of procedure that makes one wonder whether the refractive surgery of the future is surgery at all. Essentially, the procedure using riboflavin, UV light, and a few other tools like cornea topography analysis and eye tracking provides a change in corneal biomechanics to change the corneal optics, rather than use a laser to sculpt tissue. A patterned UV energy beam delivers energy to the cornea.

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