From cadaveric donation to cryopreserved total skin allografts: Transforming the Chilean skin donation model

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.

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.

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).

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.