Achieving self-sufficiency in skin allograft: A Singapore experience.

AIM: This paper describes how Singapore achieved skin allograft self-sufficiency in 2017 by adopting 5 key strategies in 2012. BACKGROUND: Singapore General Hospital (SGH) established its own allograft recovery programme in 1998 but was still dependent on overseas allograft procurement. KEY STRATEGIES: RESULTS: The allograft recovery programme expanded from 4 to all 20 institutions. Donor referrals increased by 42.9% from 35 in 2014 to over 50 currently. Donor numbers increased by 210%, rising from 4.5 per year before 2015 to an average of 14 per year from 2015 to 2022. The total allografts recovered increased by 223%, climbing from 13,000 to 42,000 annually. Cryopreservation was adopted, extending shelf life to 5.5 years and doubling storage capacity to more than 140,000 cm2 in 2022. CONCLUSION: Singapore achieved skin allograft self-sufficiency with no overseas procurement since 2017.

Psychosocial Factors, Knowledge and Attitudes Influencing Skin and Heart Valve Donation among Healthcare Professionals in Singapore.

INTRODUCTION: In Singapore, tissue donation is covered under the Medical (Therapy, Education and Research) Act. The objective of this study is to review the demographic and psychosocial factors, which may cause hesitation/unwillingness amongst healthcare professionals towards tissue donation. MATERIALS AND METHODS: A survey comprising 18-items was conducted at the Singapore General Hospital and National Heart Centre Singapore. A total of 521 individuals participated in the survey. Descriptive statistics were performed for the demographic profiles of participants, the factors leading to the support of tissue donation, reasons for hesitation/reluctance to donate tissue and motivating factors to discuss tissue donation with next-of-kin. Pearson's chi-square and Fisher's exact tests were employed to assess possible association between various factors and support towards tissue donation. Analyses were performed using Statistical Package for Social Sciences V.21.0 software. RESULTS: A total of 64.9% of participants had heard about skin donation; 48.9% had heard about heart valve donation; 4.5% were tissue pledgers. The primary reason for pro-donation was the altruism of "improving someone's quality of life". However, a majority stated they "can decide this in the later part of life" as their main reason for hesitation; 82.3% were willing to discuss their tissue donation wish with next-of-kin, while 53.1% were likely to make the decision of donation on behalf of their deceased next-of-kin. CONCLUSION: RESULTS highlighted important psychosocial and professional factors that influence the hesitation/ reluctance towards donation. Hence, there is a need to re-strategise educational efforts in accordance with the target audiences and address specific misconceptions and concerns.