KEY POINTS:
American skin is being used on New Zealand burns victims because of a substantial shortage of skin donated for grafts.
The shortages meant about 10 New Zealand victims of major burns were not able to have the best treatment - human skin - for their wounds in that
time.
Those patients were instead given either artificial skin made from a nylon mesh, or an animal-based product made from pigs' skins, the clinical director of the Middlemore Hospital-based National Burns Centre, Dr Richard Wong She, told the Herald yesterday.
Those treatments were inferior in quality and far more expensive than human-sourced skin, he said.
Real skin as opposed to artificial skin could be the difference between life and death, Dr Wong She said, but the already severe state of health of those 10 patients meant it was impossible to say whether the artificial skin contributed to their recovery or death.
The shipment of American skin was therefore a major coup for New Zealand, despite it costing more than twice as much as locally sourced skin.
It would allow the "gold-standard treatment" for the 30 to 45 New Zealand patients in need of substantial skin grafts each year, he said.
"We need that skin. I cannot stress enough how important it is to have the gold standard.
"At the surgeon's table all we want is for [the skin] to be of good quality and available. So I don't mind if that frozen packet is coming from halfway down the road or halfway around the world."
Traditionally, Auckland's coroner's mortuary had supplied enough skin to fulfil New Zealand's demand, transfusion medicine specialist Dr Richard Charlewood said.
Auckland City Hospital's intensive care unit was now also contributing to donations. But recent changes to the Coroners Act had meant fewer post-mortem examinations were being performed, reducing the amount of skin being donated, he said.
The shortage had forced New Zealand to turn to Australia for skin, but Australia often had skin shortages of its own.
The shortage of New Zealand-sourced skin was expected to ease within the next two years, as other avenues for skin donation were introduced.
Dr Charlewood said they would include intensive care units and coroners' mortuaries at other cities around the country being used for donations.
THE PROCESS
* A New Zealander, listed as an organ donor, dies at Auckland City Hospital's intensive care unit, or their body goes to the coroner's mortuary court.
* Medical checks are done on the donor and the family is asked for their consent.
* The thin top layer of the donor's legs, about 1mm thick and 4000-5000cm square, is removed and tested for infection. If suitable, the skin is frozen and stored. It can be kept for up to five years.
* It comes from its storage form in layers, like filo pastry, and is stitched on to the patient.
* Any skin, from a donor of any age or race, can be used as the body quickly rejects the new skin and it falls off after two or three weeks.
* Skin grafts are not long-term but are "the very best type of gauze", Dr Wong She said.
