Procurement of Autograft Skin from Amputated Limbs

exp date isn't null, but text field is

Following traumatic amputation, autograft skin may be harvested for later use on that same patient. If possible, skin should be harvested during the initial trauma surgery. Harvested skin can be stored for up to 14 days for later use.

If circumstances do not allow for immediate harvest, the limb may be temporarily stored in the morgue for later retrieval. The exception to this is when there is consideration that the limb itself may be reattached. In that case, it must be stored with the patient in a cooler of wet ice. Refer to the following for harvesting autograft skin:

1. Tissue excision must commence within 24 hours of amputation provided the limb was cooled with sufficient amounts of wet ice or refrigerated within 12 hours. Tissue excision must commence within 15 hours of amputation if the limb has not been cooled or refrigerated. If limb is cooled for a period of time, then not cooled for a period of time, the time period the limb is not cooled cannot exceed 15 cumulative hours.
2. If limb must be stored for later skin retrieval, it may be transported to the morgue for storage on designated limb shelf in one of the refrigerated body storage units. It must be accompanied by a completed requisition form. “No Dissection” must be written on the requisition form. Trauma staff will wrap the limb in sterile towels moistened with saline and place it in a plastic bag. Limb must be labeled with patient information, time and date of amputation, time cooled, physician and service responsible, and clearly marked “Do Not Dissect” on the plastic bag. Call Hospital Security for entrance if morgue is not staffed.
3. Log the specimen in the log book by the morgue entrance. When limb is retrieved from morgue for harvesting of skin, it must be logged out before removal.
4. If not immediately used for grafting, harvested skin may be stored by Trauma Burn Resource Center (Skin Bank) in RPMI 1640 with Glutamine for up to 2 weeks post retrieval.* Media is stored in the Skin Bank as well as in the OR Core Blood Bank Refrigerators in both Main and Mott OR’s. No more than ¼ sq. ft. of tissue per 100 ml bottle. Media must cover tissue completely.
5. Return to Skin Bank or OR Refrigerator for refrigeration within 2 hours of harvest. In the event skin retrieval does not take place, notify the morgue for disposal of limb.

*Refrigerated skin is routinely banked for up to 14 days according to current AATB Standards for Tissue Banking, however TBRC has been granted authorization to bank autograft skin for up to 30 days upon request by physician for exceptional release. Notify TBRC of request.