Annals of Burns and Fire Disasters - vol. IX - n. 1 - March 1996

THE HISTORY AND FUNCTION OF THE EURO SKIN BANK

• Concentration of know-how
• Better efficiency
• Cheaper management of all aspects
• More possibilities for research

In October 1976 the National Skin Bank was started at Beverwift. Teams were formed to go out to hospitals where a donor was available. The skin was then transported to the Beverwijk Skin Bank laboratory, where the skin was processed and stored for delivery to hospitals all over our (small) country.
At first liquid nitrogen was used to store the skin, as was the usual procedure in those days.
It soon became clear that the decision to concentrate the work was a wise one, as the Skin Bank expanded very successfully under the very motivated leadership of Mrs v. d. Syde, RN. Through the Skin Bank's own researcher - Dr M. Hoekstra - preservation of donor skin with glycerol was developed. Extensive testing of glycerol -pre served donor skin was done on pigs, and clinically through cooperation with the Beverwift Burns Centre. The clinical results were so favourable that in 1984 glycerolization became the standard preservation technique.
Glycerol preservation has many advantages over cryopreservation, since:

• Glycerol preserves the fundamental architecture of matrix proteins
• Glycerol is a slow-acting but effective antibacterial agent
• Glycerol has antiviral properties
• Glycerol probably diminishes antigenicity
• Use of glycerol is much more cost-effective than cryopreservation
• Storage can be effected in a standard household refrigerator
• Despatch can be effected at room temperature and by normal mail, using standard packing

There is much discussion about the viability of donor skin. It is our experience, based on hundreds of cases, that glycerol-preserved donor skin works as well as, or even better than, cryopreserved skin.

Fig. 1 - Office and laboratory of Euro Skin Bank. Fig. 2 - Inside the laboratory. Fig. 3 - Preparing donor skin in laminar airflow unit Fig. 4 - Storage of glycerol-preserved human cadaver skin in standard refrigerator at 4 'C.

Glycerol-preserved human cadaver skin is used successfully as a biological dressing, in the treatment of scalds, and in sandwich procedures.
As more burn centres in Europe became famfiliar with the Beverwijk Skin Bank and became frequent users, the name was changed in 1992 to Euro Skin Bank. The goal of the Euro Skin Bank is to help bum centres all over Europe with donor skin. Euro Skin Bank is a non~profit making organization and, as such, supplies skin at cost price.
In some centres it is believed that local harvesting of donor skin is much cheaper. They do not always realize how much the organization costs, which in the future will be even more, as a result of ever-increasing rules from authorities.
All procedures of harvesting, processing and storage are in compliance with strict rules for good laboratory practice (GLP) and good manufacturing practice (GMP). Delivery of skin is effected under the supervision of an independent pharmacist.
The Euro Skin Bank has its own building with all necessary equipment. The organization employs 12 people. Ongoing research, in collaboration with a number of institutes on subjects such as bacteriology, virology and matrix technology, is organised by the Euro Skin Bank.
As many burn centres had treated hundreds of burn patients with donor skin from the Euro Skin Bank it seemed appropriate to organize a symposium for users of this kind of preserved skin, in order to exchange experiences and learn from each other. Thus, in February 1993, a symposium was held on "The use of glycerol-preser-ved donor skin". The proceedings of this meeting were published in Supplement 1 of the journal Bums, vol. 20, 1994. Details about processing, handling, and clinical use are described in this Supplement.
It is our intention to organize such a meeting again in 1996. The demand for donor skin increased so rapidly that in 1994 the Skin Bank became short of donors. Co-operation with other centres was therefore organized on an international basis. We now receive skin from several countries in Europe. The organization is such that the first three steps of glycerolization are performed by the local harvesting organization, after which the skin is transported to the laboratory in Beverwijk, for final processing, quality control of packing, and despatch. This procedure ensures that the skin delivered comes up to the same high standard that has always been used. As a result of this international cooperation we are now again able to supply burn centres on demand. So far over 5 000 000 crn' have been delivered and used with no known adverse effects. Only very few requests for donor skin have come from burn centres in the Mediterranean area; we would be happy to extend our co-operation to burns specialists there.