Abdominoplasty Panniculus as a Source for Human Acellular Dermis: A Preliminary Report.

BACKGROUND: In extensive deep dermal burn injuries, split-thickness skin graft (STSG) has been the most preferred treatment option for resurfacing burn wounds. A thick split-thickness skin graft is ideal for preventing graft contracture but is associated with delayed donor healing and the lack of adequate donor skin. When applied with STSG, the dermal substitutes offer better-reconstructed skin than STSG alone. Human-derived acellular dermal matrix (HADM) obtained from cadaver skin is a dermal equivalent with good clinical outcomes. However, high cost and limited cadaver donor skin availability limit its clinical utility. Developing a low-cost preparation method and finding an alternate source of human donated skin can help reduce the cost. The objective of this study was to explore the feasibility of making HADM from abdominoplasty panniculus skin. METHODS: Skin samples were collected from the abdominoplasty panniculus of ten eligible donors with their informed consent. A combination of low-cost reagents-sodium chloride and hypotonic solution (water for injection) was used for decellularizing the skin. Characterization of the prepared Acellular Dermis Matrix prototype was done. RESULTS: The skin was deepidermized with one molar NaCl treatment at 37 °C for 24 h. The deepidermized dermis became acellular with hypotonic solution treatment at 4 °C for two weeks. The hematoxylin and eosin staining and cytotoxicity test confirmed the acellularity and non-cytotoxicity of the prepared HADM prototype. The HADM prototype also facilitated the formation of neo-epithelium in the 3D cell co-culture model. CONCLUSION: This study confirms that abdominoplasty panniculus can be a viable alternative for HADM preparation. Further characterization studies are required to prove the concept.

Establishing a 130-Bed Field Intensive Care Unit to Prepare for COVID-19 in 7 Days in Bahrain Military Hospital.

This article reports the establishment of an isolated, fully functional field intensive care unit (FICU) unit equipped with all necessary critical care facilities as a part of the national pre-emptive preparedness to treat an unexpected surge outbreak of coronavirus disease 2019 (COVID-19) patients in Bahrain. One floor of an existing car parking structure was converted into a 130-bed FICU set-up by the in-house project implementation team comprised of multidisciplinary departments. The setting was a military hospital in the Kingdom of Bahrain, and the car park was on the hospital premises. The FICU contained a 112-bed fully equipped ICU and an 18-bed step-down ICU, and was built in 7 d to cater to the intensive care of COVID-19 patients in Bahrain.