301 Autograft Storage Practices of ABA Verified Burn Centers

Abstract

The procedures used to store and maintain autograft skin can have a critical impact on the outcome of an autograft transplant. Inadequate handling and storage can result in tissue contamination, loss of graft, and/or decreased viability of the tissue. To gain insight into the storage practices for autograft skin at burn centers, a literature review was performed but it revealed little information. The data that was available showed a lack of uniformity in storage procedures. Since there are no established guidelines for these procedures, a survey was conducted to assess current ABA verified burn centers’ methods for the storage and handling of autograft tissue. An online survey was sent to each of the 71 ABA verified burn centers. The survey consisted of 10 questions pertaining to the storage and handling of autograft skin. Of the 71 surveys, 34 surveys were completed for a response rate of 48%. Half of the burn centers who responded (17 of 34) stored autograft skin. The following are the questions with results of the survey: 1. Does your burn center store autograft skin? 17 Yes / 17 No 2. What type of medium do you store autograft skin in? 7 Cell Culture Medium / 6 Normal Saline / 4 Other 3. How long do you keep autograft skin before discarding? 2 - Five Days / 8 - Fourteen Days / 7 - Other 4. How often do you change the storage medium used to store autograft skin? 1 - Every twenty-four hours / 3 - Every seventy-two hours / 10 - Do not change the storage medium / 3 - Other 5. At what temperature do you store the autograft skin? 16 above 0 to 10 degrees Celsius / 1 other 6. Do you disinfect the autograft skin? 9 Yes / 8 No 7. Do you add antibiotics to the storage medium? 10 Yes / 7 No 8. Do you culture the autograft skin/or medium for micro-organisms? 3 Yes - with a sensitivity panel / 1 Yes - without a sensitivity panel / 13 No 9. What do you culture for? 4 Bacteria / 4 Fungi / 3 Anaerobes 10. Do you have a procedure in place for when to discard autograft skin with positive culture results? 1 Yes / 8 No / 5 Physician’s Preference. Half of the surveyed burn centers do not store autograft skin. The remaining burn centers that do store autograft skin have differing storage methods. Some of the methods for storing and handling of the tissue could affect patient safety through tissue contamination, loss of graft, and/or decreased viability of the tissue. The creation of guidelines for a more uniformed practice of storing autograft skin could be created for ABA verified burn centers. This should result in better handling and storage of autograft skin that in turn could improve patient care by reducing the likelihood of tissue contamination or loss of graft.