Browsing by Author "Fonseca, Marcelo"
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Publication Cryopreserved Total Skin Allografts From Living Donors for Complex Wound Management: A New Paradigm in Regenerative Wound Care(2025) Fonseca, Marcelo; Cañete, Aldo; Mandriaza, Luana; Gómez, Jennifer; Masiá, Jaume; Marcelain, Katherine; Ibaceta, Dino; Erazo, Cristian; Gámez, Brenda; Rius, Montserrat; Disi, FlorenciaSkin 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 stand- ards. 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 cm2 of skin generated 2050 units. The discard rate was 27%, mainly due to a storage failure and isolated micro- bial 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 neovascu- lar 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.Publication From cadaveric donation to cryopreserved total skin allografts: Transforming the Chilean skin donation model(2025) Fonseca, Marcelo; Cañete, Aldo; Mandriaza, Luana; Gómez, Jennifer; Masiá, Jaume; Marcelain, Katherine; Ibaceta, Dino; Erazo, Cristian; Gámez, Brenda; Soto, Carolina; Valdés, CristóbalBackground: The clinical utility of skin allografts (SA) is well established. However, the donation and procurement of cadaveric skin-historically the primary source of SA-remain limited in many countries. A skin donation model based on the use of excess surgical tissue from body contouring procedures was introduced and compared with the traditional cadaveric donation model. Methods: A retrospective review of skin donations in Chile was conducted over two periods (2017-2019 and 2022-2024), analyzing the performance and characteristics of two donation pathways: cadaveric and living donors. Results: During the first period (2017-2019), four cadaveric donors provided a total of 10,959 cm² of skin. In the second period (2022-2024), 353 donors contributed 153,585 cm² of skin, of which 348 were living donors (131,997 cm²) and five were cadaveric (21,588 cm²). Conclusions: Initially conceived as a complementary strategy, the living donor model has evolved to become the primary source of skin allografts in Chile. This approach significantly increases the availability of SA, broadens therapeutic indications, and promotes the concept of transforming excess surgical tissue into valuable therapeutic resources. Moreover, it enables the production of cryopreserved full-thickness skin allografts (CTSA), which serve not only as temporary wound coverage but also as dermal regenerative scaffolds, particularly beneficial in the treatment of burns affecting functionally and aesthetically critical areas. This new paradigm supports a more accessible and sustainable culture of skin donation while offering promising benefits for regenerative burn care.