Variables determining the amount of microbial contamination on cadaveric allograft skin used as a biological wound dressing.
The increased availability and use of cadaveric allograft skin as a temporary burn wound dressing has emphasized the need for a complete understanding of the parameters affecting the contamination level of this material. We undertook a prospective evaluation of the allograft skin obtained from 300 cadaveric donors over 5 years. We evaluated the contribution to skin contamination of eight parameters: sex, age, race, cause of death, elapsed time postmortem before skin removal, total refrigerated storage time of the skin prior to cryopreservation, donor body area from which the skin was removed, and choice of surgical operators or teams. The only parameters significantly related to skin contamination level were the choice of surgical operator or team which prepared the body and removed the skin (P = 0.0001) and the acceptance of skin from donors when the cause of death was unknown but presumed to be from natural causes (PNC) such as myocardial infarction or cerebral vascular accident (P = 0.006). In the case of the PNC deaths, there was only a small 3.4 per cent increase in bacterial contamination and no increase in fungi or yeast, while some surgical operators were associated with five-fold more bacterial contamination and nearly 13-fold more fungal contamination than other surgical operators. We conclude that the performance of surgical operators appears to be the major determinant of the microbiological cleanliness of skin from cadaveric allograft donors.
D000367:Age Factors; D001424:Bacterial Infections / Q000635:transmission; D001458:Bandages; D001684:Biological Dressings; D002056:Burns / Q000601:surgery*; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D009181:Mycoses / Q000635:transmission; D012737:Sex Factors; D012867:Skin / Q000382:microbiology; D016038:Skin Transplantation; D013997:Time Factors; D014019:Tissue Donors