What does skin banking involve?
The Skin Bank Unit supports the Singapore General Hospital's Burns Centre, which is the only one of its kind in Singapore. The centre has about 160 to 180 patients a year. My unit's job is to see to it that there is sufficient donor skin to meet the needs of burns patients and to be ready for big emergencies.

Have there been big emergencies?
In 2002, when the Bali bombers struck the Indonesian resort island, 16 badly burnt victims were sent to us. The surgeons were operating round the clock. Meanwhile, I was on tenterhooks because we didn't have enough to manage such a sudden big number. So I called the Texas Skin Bank in the United States for help: the skin it sent arrived within 72 hours.

What do you people actually do?
We have our 'barang barang' to harvest the skin: a big suitcase with sterile, operating theatre packs. We go to where the donor is. Usually this is the mortuary, or it can be on-site; that is, the place where the person has died.

You mean, you skin corpses?
Yes, we work with the plastic surgeon on this. From 2002, when I joined the unit, until now, I've done 27 cases.

How do you feel when at work?
Now I can take the blood and gore, but I remember that it was a little stomach-churning the first time. One feels for the person who died, but one is grateful that he was willing to donate his tissue and organs for the good of others.

What do you use to harvest the skin?
With a shaver-like instrument called a dermatome. It goes across the patient's body like a mini-lawn mower.

What goes through my head when using it? That I should do it properly, so I won't waste any of the skin.

Then what happens?
When I get back to the lab, I tag the skin, wash it and check that it's free of harmful bacteria. After a week or so, the skin is ready to be trimmed, processed and put into a pouch. First, it goes into a step-down freezer that goes from 4 deg C to minus 100 deg C, getting colder by 1 deg C per minute. Then the skin goes into a liquid nitrogen tank, which is at minus 190 deg C. There, it can be stored for five years.

Sounds so CSI (Crime Scene Investigation unit, made popular in the TV series). What made you go into this job?

Actually, it's totally different. The guys in CSI are more investigative. For me, it's ensuring safety.

For example, keeping track is very important. I must know where the skin came from and where it's going to, because if there is any adverse reaction, we can quickly isolate the batch of donor skin and investigate the root cause.

Actually, the job is very mechanical. Some days I feel isolated in the lab. The impetus for me is that I also do skin culture and research into skin tissue engineering. Whatever I do I can see the results when used on a patient very quickly. As a bio-engineer, I like to see the outcomes.

What's the hardest part of your job?
Dealing with insufficient donations. In all of 2007, there was only one person who donated his skin upon death.

The number varied between two and four from 2004 to 2006. Most of our unit's allografts, or skins from dead people, are imported from the Netherlands, the United States and Australia.

A lot of people shy away from agreeing to donate the skins of loved ones who have died because there's a misconception that such a decision will leave their loved ones without their skins.

This is not true, because the skin we harvest is of a thickness of only 0.25mm to 0.4mm. The size can vary from half of a $2 dollar note to three pieces of the note lined together, depending on where we take it from - the thighs, buttocks or back - and the size of the donor. But there need be no worries about disfigurement.

E-mail: eve_yap2001@yahoo.com

- For skin donation inquiries, call the Skin Bank Unit on 6321-4974

This story was first published in the Mind Your Body supplement on Feb 20, 2008.