Development of a passive device for freezing large amounts of transplantable skin at one time in a -70 degrees C mechanical refrigerator

A simple device has been developed for the simultaneous cooling of up to 9120 cm2 of allograft skin in a flat package format. The device, named an insulated alternating-offset heat sink device, is composed of a stack of interleaved layers of 2.0-mm-thick packets of skin and 3.18-mm-thick aluminum heat sinks (each 33.0 cm long by 22.9 cm wide). Four skin packets are placed in a single layer on each heat sink plate, and the number of plates can be varied to accommodate different numbers of skin packets. Every heat sink protrudes 6.3 cm of its 33.0-cm length beyond the skin packets to make a fin for heat convection, but adjacent plates alternate the direction of their fin protrusion so that the layers of plates alternate in their 6.3-cm offset. Insulation layers of 2.54-cm-thick expanded polystyrene are placed on the exposed surfaces of the top and bottom heat sinks in the stack, and the stack is held together by rubber bands. The device is cooled in a -70 degrees C mechanical refrigerator. Maximal cooling rates of -1.8 degrees C min-1 are obtained for both 6- and 11-plate devices, and -3.0 degrees C min-1 for a 2-plate device. The exothermic temperature plateaus associated with skin cooled in these devices are 1.5-1.8 min in duration. Skin cooled by this technique maintains levels of glucose oxidation similar to those associated with skin cooled by liquid nitrogen vapor at a controlled rate of -1 degree C min-1, provided rapid warming is employed after -70 degrees C storage. The development of this device provides a method for the simple, low-cost cryopreservation of the large amounts of allograft skin obtained from a cadaveric donor.

Skin preservation at 4 degrees C: a species comparison

There are numerous experimental studies in the literature regarding skin storage and preservation. These studies are difficult to interpret due to the variety of storage techniques utilized and the number of different animal species used as skin donors. This study utilized a single cold storage protocol to test the effect of species variation on skin graft viability. Donor skin was obtained from five animal species and human surgical panniculectomy specimens. The skin was stored in modified Roswell Park Memorial Institute (RPMI) 1640 tissue culture media at 4 degrees C. Stored skin was transplanted to surgically created defects on athymic (nude) mice after specific storage intervals. Ten days after transplantation, the grafts were examined by gross and microscopic techniques. The viability of mouse, rat, and dog skin was significantly different from human skin, while stored rabbit and pig skin were similar to human skin. These results demonstrate the difficulty of applying the data of skin storage studies from nonhuman species to clinical practice. The data indicate that rabbit and pig skin may be used in laboratory studies of skin preservation at 4 degrees C with a strong likelihood that the results may be of clinical relevance in predicting the behavior of human skin under similar storage conditions.

Cryopreservation of skin using an insulated heat sink box stored at -70 degrees C

The cooling of skin to a temperature of -70 degrees C was carried out by two methods: programmed controlled-rate (PCR) cooling at -1 degree C min-1 to -70 degrees C, and variable-rate cooling to -70 degrees C in an insulated heat sink box (IHSB). The IHSB was constructed of polystyrene and contained two aluminum heat sinks placed one on each side of flat packets of skin. The IHSB containing skin was cooled in a -70 degrees C constant-temperature refrigerator. When using the IHSB, the insulation provides a slow cooling rate while the paired heat sinks provide even heat flow across the top and bottom surfaces of the flat skin packets, minimizing the duration and potential damaging effects of the exothermic temperature plateau which occurs at the freezing point. When followed by 24-hr storage at -70 degrees C and warming at about 316 degrees C min-1, the IHSB cooling method was equivalent to the PCR method in generating a suitably slow cooling rate of -1 to -2 degrees C min-1, and maintaining about 80% of normal skin cell glucose metabolism. The development of the IHSB cooling system provides a method for the simple, cost-efficient cryopreservation of small amounts of autograft skin, such as those remaining from surgical procedures, and can also provide an allograft skin banking capability to any facility possessing a -70 degrees C refrigerator.

Integrated study of the structural and metabolic degeneration of skin during 4 degrees C storage in nutrient medium

Integrated studies of the structural and metabolic degradation of skin during 4 degrees C refrigerated storage in Eagle's minimal essential medium were undertaken. Skin degeneration occurred in three phases during the first 7 weeks of refrigeration. Phase I (Days 1-10) was characterized by the release of cellular debris and leakage of intracellular enzymes into the storage medium, shrinkage of the epithelium, and vacuolization and cell loss in the vascular bundles of the papillary dermis. The release of debris was accelerated by a 2-hr incubation of the skin at 25 and 37 degrees C prior to 4 degrees C storage. The ability of dermal cells to metabolize glucose, aspartic acid, glutamic acid, ornithine, and orotic acid to carbon dioxide dropped to low levels during Phase I. Phase II (Days 11-30) was characterized by a period of less intense physical decay, but with continued cellular and vascular degeneration. By the third week, there was nearly total loss of recognizable vascular bundles in the papillary dermis. Phase III (Days 31-58) was characterized by the exfoliation of large amounts of cellular debris and significant loss of structural integrity. By the fifth week, nearly all of the nuclei in the epidermis became pyknotic, and the vascular bundles of the reticular dermis were lost. Previous reports of the maximum allowable duration of skin storage at 0-8 degrees C have ranged from 0.3 to 185 days; however, our findings suggest that the useful limit of refrigerated skin storage in nutrient medium is 1 week if physiological function and structural integrity are desired for optimum postgraft performance.