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VITAL NEED: Donated skin is used as a temporary dressing for severe burns. -- ST PHOTO: DESMOND WEE
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WHEN three-month-old Ryan Wong died from complications following surgery for a cleft lip at the end of January, his parents, in a rare gesture, donated his skin.
That decision made him the youngest organ donor here.
His parents, Mr Norman Wong, 46, and his wife Juliet, 37, also wanted to donate the rest of their son's organs, but were told they were either too small or not yet fully developed.
But his skin was usable, so a small piece was taken off his back for the skin bank here.
'This way, he will be contributing to saving someone's life,' said Mrs Wong.
Few would do what the Wongs did. Last year, only one person donated his skin upon death, and between 2004 and 2006, no more than two to four donors surfaced each year.
The shortage in donations to the skin bank was recently raised in Parliament by Mr Sam Tan, an MP for Tanjong Pagar GRC, who called for more donations to be made.
He told The Straits Times via e-mail that skin would be needed in the event of mass casualties from industrial accidents or terrorist attacks.
Skin, the largest organ in the human body, is not covered under the 21-year-old Human Organ Transplant Act, so hospital staff have to ask the deceased's family to consent to a donation.
The answer has often been 'no', primarily because people believe - mistakenly - that donating a dead person's skin involves disfiguring him.
Given this widespread misconception, it is no wonder the answer is often in the negative.
Associate Professor Colin Song, director of the Singapore General Hospital's Burns Centre, said: 'Asking for organs from a grieving family is already difficult enough. Asking for skin as well can be seen as being rather extreme.'
He gives the assurance that donors are not totally stripped of their skin.
Only the outermost layer, between 0.25mm to 0.4mm thick, is taken from flat surfaces like the thighs and back, he explained.
Up to 2,000 sq cm of skin - approximately the size of a page of this newspaper - can be harvested from an adult.
'The harvested areas will appear slightly pale compared with the rest of the body where the skin has been left intact,' said Prof Song.
These areas, when concealed with clothing, will not mar the looks of the deceased.
Prof Song added that skin donations are rare also because people do not know the benefits of skin donation.
Donated skin is used as a temporary dressing for severe burns to reduce the growth of bacteria and loss of the patient's vital fluids.
It is usually discarded three weeks later, but by then, new skin - cultivated in a laboratory from the patient's own cells - would have grown enough to be used as a replacement.
To be operationally ready in a crisis, the skin bank needs 60,000 sq cm of skin.
The bank now has that much skin in storage but Prof Song said it could do with more donations.
Singapore has had to import skin from Australia, the United States and, recently, the Netherlands, at $200 for a piece about the size of an adult's palm.
When 16 burn victims were sent to Singapore following the Bali bombing in 2002, the skin bank here imported skin from its American counterpart in Texas in 72 hours.
Synthetic skin can also be used, but at $4,000 for a sheet the size of a piece of tissue paper, it is four times as expensive as imported skin.
Harvested skin is processed and packed individually, then stored in deep freeze, at -196 deg C. Skin stored this way can be kept for up to five years.
Mr Wong said: 'We are waiting for the day the skin bank would call to inform us that Ryan's skin is being used to save someone's life. That is when we know his legacy - however small - lives on.'
juditht@sph.com.sg
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