The Yale Skin Bank (YSB), founded in 1984, operates within the Department of Surgery, Section of Plastic Surgery, and is under the Directorship of John Persing, M.D. The mission of the YSB is the recovery, preservation and distribution of life-saving, viable allograft skin to burn centers in the U.S. and abroad.

Allograft skin is obtained from donors meeting the universally accepted criteria for tissue and organ donation. Once consent is obtained from next-of-kin, a thorough medical history is determined, in order to exclude from donation those individuals with risk of disease communication. Donors must be without history of risk factors associated with HIV, malignancy, autoimmune or infectious diseases or other conditions as determined by the medical director. The donor skin must be free of abrasions, scars, and deformities in at least 75% of the body surface area. Recovery of skin from the donor must be performed within 24 hours post mortem, provided the body has been stored in a morgue refrigerator.

Skin recovery from suitable donors is conducted with the cooperation of the two regional organ procurement organizations, the New England Organ Bank and the North East Organ Procurement Organization as well as the Connecticut Eye Bank. It is important to recognize that while "beating heart," brain dead individuals are considered as potential skin donors, the overwhelming majority of skin donations are recovered from asystolic donors. The viability of skin persists for at least 24 hr after clinical death under mortuary storage conditions.

Please note that we do not recover skin from living donors. This includes people undergoing cosmetic procedures.

Research efforts of YSB have focused in two main arenas: a) preservation and augmentation of viability of donated allograft skin, and b) enhancement of our understanding of the biology of dermis and its interactions with epidermis and the wound bed. The now widely clinically employed strategy known as "composite auto-allo skin replacement" was developed by Dr. Charles Cuono and colleagues, bringing together several of the research advances made by the YSB. This technique involves primary grafting of excised major burn wounds with viable cryopreserved allograft skin, and rapid cell culture expansion of the patient's own epidermis. Prior to wholesale rejection of the engrafted allograft skin, the highly immunoreactive allo-epidermis is removed by dermabrasion, and the exposed, vascularized allo-dermis is resurfaced with the culture expanded autologous epidermis. This duplex reconstitutes a fully functional skin replacement. In longitudinal studies, validated by investigators worldwide, the allo-dermis, freed of its reactive allo-epidermis, is not rejected, nor is it resorbed. Rather, it persists and functions as dermis. The composite auto-allo technique is presently the only strategy which is capable of permanently replacing missing dermis with dermis, as opposed to scar.

Requests for information about the Yale Skin Bank should be directed to Bruce Fichandler, PA, Executive Director, at
(203) 785-2573 or e-mail to:
Bruce.Fichandler@yale.edu