Achieving self-sufficiency in skin allograft: A Singapore experience.

This paper describes how Singapore achieved skin allograft self-sufficiency in 2017 by adopting 5 key strategies in 2012. Singapore General Hospital (SGH) established its own allograft recovery programme in 1998 but was still dependent on overseas allograft procurement. 1. Expanding the donor pool: a. increasing coverage to all hospitals, b. adopting mobile recovery sets and c. increasing skin donor upper age limit from 75 to 90. 2. Reducing allograft usage by utilising Biobrane as part of SGH Burns protocol. 3. Extending allograft shelf-life by adopting cryopreservation. 4. Tapping on the existing national organ and tissue donation network. 5. Expanding public outreach efforts. The allograft recovery programme expanded from 4 to all 20 institutions. Donor referrals increased by 42.9% from 35 in 2014 to over 50 currently. Donor numbers increased by 210%, rising from 4.5 per year before 2015 to an average of 14 per year from 2015 to 2022. The total allografts recovered increased by 223%, climbing from 13,000 to 42,000 annually. Cryopreservation was adopted, extending shelf life to 5.5 years and doubling storage capacity to more than 140,000 cm2 in 2022. Singapore achieved skin allograft self-sufficiency with no overseas procurement since 2017. ● 5 key strategies were used to achieve skin allograft self-sufficiency. ● Donor pool was expanded. ● Allograft shelf-life was extended with cryopreservation. ● Allograft usage was reduced by adopting Biobrane as part of burns protocol. ● Donor referrals, donor numbers and total allografts recovered increased substantially. [ABSTRACT FROM AUTHOR]