The importance of the bacterial flora in cadaver homograft donor skin: Bacterial flora in cadaver homograft

The increased use of cadaveric homograft skin, made possible through the development of skin banking techniques, has emphasized the necessity of bacteriologic control of transplant tissue. Since the inoculation of burn wounds with pathogenic organisms is known to be potentially lethal, the lack of adequate quality assurance programs for controlling donor graft flora could represent a significant hazard. This potential hazard was evaluated by studying bacterial flora isolates from 362 continuous cadaver donors harvested during an 18-month period. Positive cultures were found in 169 (46.6%) donor skins. Fifty-one (14%) of the samples grew a variety of potentially pathogenic organisms. Included in the potential pathogenic isolates were 36 aerobic gram-negative rods, three gram-positive cocci, and eight anaerobic organisms, six Clostridial species, and two Bac-teroides species. All 51 of these donations were rejected for transplant. The remaining 118 cases grew indigenous skin flora and were accepted for transplant. These results emphasize the importance of routine culture assessment of all donor homografts before transplant. Additionally, the unexpected finding of anaerobic organisms (unpredicted by preculture donor screening) in the donor population indicates a need for a system of isolation and identification of uncommon or unexpected skin flora.