Tuesday, March 23, 2010
First, I would like to thank the beautiful Lady_Judah for sending me a SparkMail message and inspiring me to post this blog. You see, the other day I posted a blog about a woman I met at Walmart who talked about donating her skin and how she was waiting on her doctor to call back. I had done a little research, but truly, between you and me, there is no rush. I am not thinking I'll see excess skin for a while. I found a few promising links and a few that weren't. Lady_Judah did some research of her own and came up with a website stating skin donation was a myth.
So, with her email, I have been poking around a bit more. The ability to donate skin is a myth... and the ability to donate skin is not a myth.
Allow me to explain...
Donating skin is a myth in regards to (1) getting your procedure paid for and (2) being used on burn patients. Neither of these is going to happen. The stories normally start out "a friend of mine had a friend who lost a lot of weight." Those stories should automatically be filed away in the urban legend category - or at least a story that is suspect of being an urban legend. The reason the medical community normally does not remove skin for donation is because it is a very pricy adventure. The procedure itself removes a hunk of skin and in reality, a burn center will only use the top-most layer of skin. Then, of course, you have to add in testing for certain conditions like HIV, hepatitis, etc. So you are talking not only the cost to remove your skin, but the cost to prepare the skin for use on another person. Because of the cost, if a burn center was going to graft skin from a living person to a patient, the stretched, marked skin is not going to be first choice. The physicians are going to want to use supple, firm skin to give the patient the best case scenario of healing.
There is also the issue that skin normally has a 100% rejection rate in burn patients. When an individual's skin is damaged that badly as it would be from a severe burn, the only skin that will work is the skin of the patient. So, in the end, when considering expense and treatment needs, a burn patient will receive a graft from a cadaver - not a living person. Another option for burn centers is the use of pig skin. These two options are used as a last resort, if the patient does not have enough area on the body that was not burned. These two options are not permanent - they will not take to the patient's body and in a few days will die off. They are normally used to keep a patient alive until the individual can grow their own skin or their skin can be grown in a laboratory to cover the areas being temporarily protected by the cadaver/swine skin grafts.
None of this means that it cannot be done, it only means that it is rarely done.
So, with all of that said, how in the world could a person donate excess skin? How is it not a myth?
First, we have to debunk the concept of the word donate. People often think that when donating excess skin, it is similar to donating blood or donating bone marrow - that it will be done at no cost to them. Incorrect. The word donate simply means 'to give at no cost' - you can give your skin to someone, but it will cost you the surgery. Then, once removed, your gift can be made. Normally, an individual who is able to donate skin is taking on the cost of skin removal surgery themselves. The surgery is too expensive for most facilities to cover, especially for an item that can be gotten from a cadaver.
So, with the definition of 'donating skin' cleared up as far as it is a donation, but the surgery is not paid for - who in the world, if not a burn center, would want the excess skin resulting from weight loss?
Keeping burn centers in mind - excess skin can be used in research. The skin may never touch another living person, but it can help researchers study burns and burn victims. It is possible through research that a cheaper, more viable means of skin grafts from living donors could be found.
In addition to this, as I said earlier, it isn't unheard of that a physician would use live tissue for a burn graft, it is only rare. The truth is, the need for skin grafts has exceeded the supply available through cadavers. To answer this problem, the Musculoskeletal Transplant Foundation (MTF) is building a living tissue bank. There are only a handful of surgeons that callaborate with the foundation on its living skin program. So, if you are going to have the surgery, you may want to talk with your plastic surgeon about donating your skin. There is even a contact form on the MTF website to help link you to a surgeon in your area. If your surgeon is linked to the living tissue bank, he or she can assess your skin and identify if it is a viable donation.
So, to wrap this up - donating skin is possible but its not what you think. Your surgery will not be paid for. In fact, the MTF prohibits buying any tissue and paying for your surgery is considered a form of buying tissue. Your skin may not be a viable candidate for donation or it is possible that donating skin isn't possible in your area as this is a relatively new endeavor.
My conversation with the woman at Walmart leaves me a little hopeful that she has found someone local who has a use for living skin donations; however, I don't think I'm going to have to worry about it for a while. By the time I go under the knife, provided it doesn't snap back where it started, then there may be more options for skin donation. Medical advancements come fast and furious - what does not exist one day may be breaking news the next.