Establishing a national network for skin procurement: Overview and experience at National Skin Bank of Taiwan.

Abstract

Treating severe burn injuries is still an intractable issue despite significant advances in clinical practice guidelines of burn care. When autologous skin grafts are not available immediately, skin allografts are considered the cornerstone of burn wound coverage. This paper describes how Taiwan achieved skin allograft self-sufficiency after 2020 and shares our experience of building standard operating procedures for the Taiwan skin bank. The standard practices of the Taiwan skin bank were demonstrated. We reviewed skin donors (n = 145) between January 2019 and December 2024. Skin allograft characteristics (size, and bacteriological and mycological results) were collected and analyzed. The annual inventory amount was calculated. From January 2020 to December 2024, 107 (79.25%) were male and 28 (20.75%) were female. The donors' ages ranged from 17 to 75 years, with the highest proportion (46.66%) falling within the 45-65 years old age group. The total surface area of harvested skin was 499,231 cm². The total loss amount during skin processing was 67,565 cm². The total storage amount was 431,666 cm². The bacteriological results revealed 12.88% average infection rate. The average annual skin storage amount increased from 27,345 cm² to 86,333 cm² annually, and achieved self-sufficiency after 2020. Due to limited skin allografts during the large-scale burn emergencies of 2015, we established national skin bank and implemented domestic collaboration for skin procurement. Taiwan achieved skin allograft self-sufficiency after 2020.