Cryopreserved Total Skin Allografts From Living Donors for Complex Wound Management: A New Paradigm in Regenerative Wound Care
Journal
International Wound Journal
ISSN
1742-4801
Date Issued
2025-09
Author(s)
Marcelo Fonseca
Aldo Cañete
Luana Mandriaza
Jennifer Gómez
Jaume Masiá
Katherine Marcelain
Dino Ibaceta
Cristian Erazo
Brenda Gámez
Florencia Disi
Type
journal-article
Abstract
<jats:title>ABSTRACT</jats:title><jats:p>Skin allografts are essential in managing complex wounds, yet their availability is limited by low post‐mortem donation rates. Skin harvested during body contouring surgeries offers a novel and sustainable source to expand tissue supply. We conducted a retrospective descriptive study at the Tarapacá Skin and Tissue Bank from January 2022 to December 2024. All donations from body contouring surgeries were processed as cryopreserved total skin allografts following national tissue banking standards. Variables included donor demographics, harvested area, units produced, microbiological results, and discard rates. To describe clinical performance, we present our group's initial clinical series of treated patients. From 248 living donors (mean age 41.3 years), 81 293 cm<jats:sup>2</jats:sup> of skin generated 2050 units. The discard rate was 27%, mainly due to a storage failure and isolated microbial contamination. Clinically, all patients achieved complete initial graft take, followed by gradual necrotic eschar formation at an average of 21 days. Eschar removal revealed vital tissue firmly adhered to the recipient bed, rich in fibroblasts and neovascular structures. Subsequent management included either escharectomy with split‐thickness autografting over the neodermis, or spontaneous eschar lysis and skin regeneration, with the graft functioning as a dermal regenerator. This model increases tissue availability while providing allografts with both coverage and dermal regenerative properties.</jats:p>