Skin shortage crisis for burns victims

By MONIQUE DEVEREUX health reporter

A shortage of skin donors has pushed specialist hospital burns units to crisis point.

Skin has had to be imported from Australia for at least one critical patient.

Middlemore and Kidz First hospitals' burns unit co-directors Dr Stephen Mills and Dr Michael Muller said there was only enough donor skin in supply in Auckland to help one more serious burns victim.

"There's definitely enough for one, although we may be just able to help the one after that. That's a crisis," Dr Muller said.

In one operation, just before New Year, Dr Muller had to order donor skin from a private cultivation lab in Brisbane.

Burns units at Waikato and Christchurch hospitals are not as concerned about the shortage, but tend to deal with smaller burns.

Donor skin is a temporary measure and is placed on parts of the body that are weight-bearing - the back, buttocks and thighs - and are most likely to be rubbed raw while the patient recovers in bed.

The skin stays on for up to two weeks, helping to repair the blood vessels and to control the patient's pain.

Permanent grafts of artificial skin or skin taken from another part of the patient's body, then replace the donor skin.

In the past three months, the Middlemore and Kidz First burns units have dealt with at least five serious cases, including that of Gareth MacFadyen, who died after his grass skirt caught fire at the Merrill Lynch Christmas party.



Dr Mills said anyone with burns to more than 30 per cent of their body was in the serious category, where the risks and complications were potentially fatal.

The sudden influx of serious cases is the main reason for the skin shortage.

Registering as a skin donor is done in the same way as for donating other organs, through the driver-licence system.

But next of kin needed to be aware of it, said Dr Mills.

"People just don't seem to be aware that this is an option, and not enough people are donating. That's partly causing this shortage - that and the number of serious cases all in a short space of time."

Hospital bereavement teams - who approach families about dying patients becoming donors - may also not realise the importance of donor skin, Dr Mills said.



The skin is removed under sterile operating procedures and the donor's blood and tissues are carefully screened for HIV and hepatitis.

Dr Mills said it was taken from parts of the body that were not visible.

Unlike most other Western countries, New Zealand does not have its own skin cultivation facilities, something Dr Mills and Dr Muller are constantly frustrated by.

Some of the best treatment results are gained by using the patient's own skin, which can be "grown" in a skin bank from a small sample. It is extremely beneficial with facial burns because cultivation of their own skin gives the patient the correct pigmentation.

Dr Muller said Rory Morunga, 13, who is recovering in Kidz First burns unit after his arm and back were badly burned, was a successful example of being able to match the correct skin colour to the patient.

A skin bank would cost around $1 million to set up and the Middlemore doctors said they had started lobbying "everywhere" for money.

Dr Muller said a New Zealand skin cultivation laboratory could save the lives of 10 people a year.