542 Lessons Learned from Implementation and Management of Skin Allograft Banking Programs in Low- and Middle-income Countries: A Systematic Review
Abstract Introduction Wound excision and temporary coverage with a biologic dressing can improve survival for patients with large burns. Allograft skin possesses many of the ideal properties of biologic dressings and can play a major role in the management of large burns when autologous tissue is no...
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Veröffentlicht in: | Journal of burn care & research 2020-03, Vol.41 (Supplement_1), p.S109-S110 |
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creator | Roberson, Jeffrey L Pham, Julie Shen, Jolie Stewart, Kelly Adu, Emmanuel Mehta, Kajal Pedraza, Morales Allorto, Nikki L Pham, Tam N Stewart, Barclay T |
description | Abstract
Introduction
Wound excision and temporary coverage with a biologic dressing can improve survival for patients with large burns. Allograft skin possesses many of the ideal properties of biologic dressings and can play a major role in the management of large burns when autologous tissue is not available or the patient’s condition does not allow safe autografting. Healthcare systems in low- and middle-income countries (LMICs) rarely have access to allografts, which may contribute to limited survival in large burns. Therefore, we aimed to describe the lessons learned from the implementation and maintenance of tissue banks in LMICs to guide system planning.
Methods
PubMed, MEDLINE, CINAHL, and World Health Organization (WHO) Catalog were systematically searched with database-specific headings and language to represent a priori terms (e.g., skin, allograft, tissue bank) and all LMICs as defined by The World Bank. Data regarding tissue banking programs (e.g., date of creation, location, lead agency, functions, products), governance, capital investments, safety, maintenance and operations, costs per donation, ethics and sociocultural issues were extracted and described in a narrative synthesis.
Results
The search returned 3,346 records. After eliminating duplicates and non-relevant records, 33 reports were analyzed. The synthesis represented tissue banks from 17 countries. Commonly reported barriers to ideal or planned implementation included high capital costs and operational costs per graft, opt-in donation schemes, and sociocultural stigma around donation and grafting. Reports repeatedly recommended: i) developing a legal framework for oversight, accreditation and ethical practice; ii) engaging diverse stakeholders (e.g., government and non-governmental agencies, community and religious stakeholders, health officials) to improve donation and transplantation rates, iii) creating regional training hubs, and iv) facilitating international cooperation across tissue banking programs to improve transplantation efficiency.
Conclusions
Many lessons were learned from the development and management of tissue banks around the world. The availability of skin allografts can be improved through strategic investments in international governance and regulatory structures, regional cooperation and training initiatives, standardized protocols, and inclusive public awareness campaigns. Capacity-building efforts that involve key stakeholders may increase rates of transpla |
doi_str_mv | 10.1093/jbcr/iraa024.170 |
format | Article |
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Introduction
Wound excision and temporary coverage with a biologic dressing can improve survival for patients with large burns. Allograft skin possesses many of the ideal properties of biologic dressings and can play a major role in the management of large burns when autologous tissue is not available or the patient’s condition does not allow safe autografting. Healthcare systems in low- and middle-income countries (LMICs) rarely have access to allografts, which may contribute to limited survival in large burns. Therefore, we aimed to describe the lessons learned from the implementation and maintenance of tissue banks in LMICs to guide system planning.
Methods
PubMed, MEDLINE, CINAHL, and World Health Organization (WHO) Catalog were systematically searched with database-specific headings and language to represent a priori terms (e.g., skin, allograft, tissue bank) and all LMICs as defined by The World Bank. Data regarding tissue banking programs (e.g., date of creation, location, lead agency, functions, products), governance, capital investments, safety, maintenance and operations, costs per donation, ethics and sociocultural issues were extracted and described in a narrative synthesis.
Results
The search returned 3,346 records. After eliminating duplicates and non-relevant records, 33 reports were analyzed. The synthesis represented tissue banks from 17 countries. Commonly reported barriers to ideal or planned implementation included high capital costs and operational costs per graft, opt-in donation schemes, and sociocultural stigma around donation and grafting. Reports repeatedly recommended: i) developing a legal framework for oversight, accreditation and ethical practice; ii) engaging diverse stakeholders (e.g., government and non-governmental agencies, community and religious stakeholders, health officials) to improve donation and transplantation rates, iii) creating regional training hubs, and iv) facilitating international cooperation across tissue banking programs to improve transplantation efficiency.
Conclusions
Many lessons were learned from the development and management of tissue banks around the world. The availability of skin allografts can be improved through strategic investments in international governance and regulatory structures, regional cooperation and training initiatives, standardized protocols, and inclusive public awareness campaigns. Capacity-building efforts that involve key stakeholders may increase rates of transplantations.
Applicability of Research to Practice
Ubiquitous challenges in implementing and maintaining tissue banks represent important lessons in program planning to improve allograft availability for patients in countries of all national income levels.</description><identifier>ISSN: 1559-047X</identifier><identifier>EISSN: 1559-0488</identifier><identifier>DOI: 10.1093/jbcr/iraa024.170</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><ispartof>Journal of burn care & research, 2020-03, Vol.41 (Supplement_1), p.S109-S110</ispartof><rights>American Burn Association 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids></links><search><creatorcontrib>Roberson, Jeffrey L</creatorcontrib><creatorcontrib>Pham, Julie</creatorcontrib><creatorcontrib>Shen, Jolie</creatorcontrib><creatorcontrib>Stewart, Kelly</creatorcontrib><creatorcontrib>Adu, Emmanuel</creatorcontrib><creatorcontrib>Mehta, Kajal</creatorcontrib><creatorcontrib>Pedraza, Morales</creatorcontrib><creatorcontrib>Allorto, Nikki L</creatorcontrib><creatorcontrib>Pham, Tam N</creatorcontrib><creatorcontrib>Stewart, Barclay T</creatorcontrib><title>542 Lessons Learned from Implementation and Management of Skin Allograft Banking Programs in Low- and Middle-income Countries: A Systematic Review</title><title>Journal of burn care & research</title><description>Abstract
Introduction
Wound excision and temporary coverage with a biologic dressing can improve survival for patients with large burns. Allograft skin possesses many of the ideal properties of biologic dressings and can play a major role in the management of large burns when autologous tissue is not available or the patient’s condition does not allow safe autografting. Healthcare systems in low- and middle-income countries (LMICs) rarely have access to allografts, which may contribute to limited survival in large burns. Therefore, we aimed to describe the lessons learned from the implementation and maintenance of tissue banks in LMICs to guide system planning.
Methods
PubMed, MEDLINE, CINAHL, and World Health Organization (WHO) Catalog were systematically searched with database-specific headings and language to represent a priori terms (e.g., skin, allograft, tissue bank) and all LMICs as defined by The World Bank. Data regarding tissue banking programs (e.g., date of creation, location, lead agency, functions, products), governance, capital investments, safety, maintenance and operations, costs per donation, ethics and sociocultural issues were extracted and described in a narrative synthesis.
Results
The search returned 3,346 records. After eliminating duplicates and non-relevant records, 33 reports were analyzed. The synthesis represented tissue banks from 17 countries. Commonly reported barriers to ideal or planned implementation included high capital costs and operational costs per graft, opt-in donation schemes, and sociocultural stigma around donation and grafting. Reports repeatedly recommended: i) developing a legal framework for oversight, accreditation and ethical practice; ii) engaging diverse stakeholders (e.g., government and non-governmental agencies, community and religious stakeholders, health officials) to improve donation and transplantation rates, iii) creating regional training hubs, and iv) facilitating international cooperation across tissue banking programs to improve transplantation efficiency.
Conclusions
Many lessons were learned from the development and management of tissue banks around the world. The availability of skin allografts can be improved through strategic investments in international governance and regulatory structures, regional cooperation and training initiatives, standardized protocols, and inclusive public awareness campaigns. Capacity-building efforts that involve key stakeholders may increase rates of transplantations.
Applicability of Research to Practice
Ubiquitous challenges in implementing and maintaining tissue banks represent important lessons in program planning to improve allograft availability for patients in countries of all national income levels.</description><issn>1559-047X</issn><issn>1559-0488</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqFkE9PwzAMxSMEEmNw55g76ua26ZJyGxN_JhWB2A7cKi9Npow2mZJu074Gn5iOTVw5WM969rOlHyG3MQxiyNPhaiH90HhESNgg5nBGenGW5REwIc7_ev55Sa5CWAEwBjzrke-MJbRQITgbOkVvVUW1dw2dNutaNcq22BpnKdqKvqLF5a9HnaazL2PpuK7d0qNu6QPazljSd38wmkC7aeF20TFpqqpWkbHSNYpO3Ma23qhwT8d0tg-taronkn6orVG7a3KhsQ7q5qR9Mn96nE9eouLteToZF5HkHCKM5UKlaZWPGEvZSCBHyKECKZI0VmoBqdQoGM8S3lWSiErokQYtWaZzIfO0T-B4VnoXgle6XHvToN-XMZQHpOUBaXlCWnZIu8jdMeI26_-3fwDC0HuI</recordid><startdate>20200303</startdate><enddate>20200303</enddate><creator>Roberson, Jeffrey L</creator><creator>Pham, Julie</creator><creator>Shen, Jolie</creator><creator>Stewart, Kelly</creator><creator>Adu, Emmanuel</creator><creator>Mehta, Kajal</creator><creator>Pedraza, Morales</creator><creator>Allorto, Nikki L</creator><creator>Pham, Tam N</creator><creator>Stewart, Barclay T</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20200303</creationdate><title>542 Lessons Learned from Implementation and Management of Skin Allograft Banking Programs in Low- and Middle-income Countries: A Systematic Review</title><author>Roberson, Jeffrey L ; Pham, Julie ; Shen, Jolie ; Stewart, Kelly ; Adu, Emmanuel ; Mehta, Kajal ; Pedraza, Morales ; Allorto, Nikki L ; Pham, Tam N ; Stewart, Barclay T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c770-a1cbe33d96443468a7a090d0c8231eeb03cfa847527752228d8f6f0fc45f98c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roberson, Jeffrey L</creatorcontrib><creatorcontrib>Pham, Julie</creatorcontrib><creatorcontrib>Shen, Jolie</creatorcontrib><creatorcontrib>Stewart, Kelly</creatorcontrib><creatorcontrib>Adu, Emmanuel</creatorcontrib><creatorcontrib>Mehta, Kajal</creatorcontrib><creatorcontrib>Pedraza, Morales</creatorcontrib><creatorcontrib>Allorto, Nikki L</creatorcontrib><creatorcontrib>Pham, Tam N</creatorcontrib><creatorcontrib>Stewart, Barclay T</creatorcontrib><collection>CrossRef</collection><jtitle>Journal of burn care & research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roberson, Jeffrey L</au><au>Pham, Julie</au><au>Shen, Jolie</au><au>Stewart, Kelly</au><au>Adu, Emmanuel</au><au>Mehta, Kajal</au><au>Pedraza, Morales</au><au>Allorto, Nikki L</au><au>Pham, Tam N</au><au>Stewart, Barclay T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>542 Lessons Learned from Implementation and Management of Skin Allograft Banking Programs in Low- and Middle-income Countries: A Systematic Review</atitle><jtitle>Journal of burn care & research</jtitle><date>2020-03-03</date><risdate>2020</risdate><volume>41</volume><issue>Supplement_1</issue><spage>S109</spage><epage>S110</epage><pages>S109-S110</pages><issn>1559-047X</issn><eissn>1559-0488</eissn><abstract>Abstract
Introduction
Wound excision and temporary coverage with a biologic dressing can improve survival for patients with large burns. Allograft skin possesses many of the ideal properties of biologic dressings and can play a major role in the management of large burns when autologous tissue is not available or the patient’s condition does not allow safe autografting. Healthcare systems in low- and middle-income countries (LMICs) rarely have access to allografts, which may contribute to limited survival in large burns. Therefore, we aimed to describe the lessons learned from the implementation and maintenance of tissue banks in LMICs to guide system planning.
Methods
PubMed, MEDLINE, CINAHL, and World Health Organization (WHO) Catalog were systematically searched with database-specific headings and language to represent a priori terms (e.g., skin, allograft, tissue bank) and all LMICs as defined by The World Bank. Data regarding tissue banking programs (e.g., date of creation, location, lead agency, functions, products), governance, capital investments, safety, maintenance and operations, costs per donation, ethics and sociocultural issues were extracted and described in a narrative synthesis.
Results
The search returned 3,346 records. After eliminating duplicates and non-relevant records, 33 reports were analyzed. The synthesis represented tissue banks from 17 countries. Commonly reported barriers to ideal or planned implementation included high capital costs and operational costs per graft, opt-in donation schemes, and sociocultural stigma around donation and grafting. Reports repeatedly recommended: i) developing a legal framework for oversight, accreditation and ethical practice; ii) engaging diverse stakeholders (e.g., government and non-governmental agencies, community and religious stakeholders, health officials) to improve donation and transplantation rates, iii) creating regional training hubs, and iv) facilitating international cooperation across tissue banking programs to improve transplantation efficiency.
Conclusions
Many lessons were learned from the development and management of tissue banks around the world. The availability of skin allografts can be improved through strategic investments in international governance and regulatory structures, regional cooperation and training initiatives, standardized protocols, and inclusive public awareness campaigns. Capacity-building efforts that involve key stakeholders may increase rates of transplantations.
Applicability of Research to Practice
Ubiquitous challenges in implementing and maintaining tissue banks represent important lessons in program planning to improve allograft availability for patients in countries of all national income levels.</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/jbcr/iraa024.170</doi></addata></record> |
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title | 542 Lessons Learned from Implementation and Management of Skin Allograft Banking Programs in Low- and Middle-income Countries: A Systematic Review |
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