Understanding and Perceptions of Skin Donation and Skin Banking among Health Care Professionals – Tertiary Care Centre in Eastern India

Introduction: The skin is our body's most diverse organ. Other organs, such as the kidneys and liver, could be impaired and somehow still function, but the loss of 40percent of someone's skin can be fatal. In developing countries, burns led to the deaths of the majority of people. The study aimed to establish the relationship between medical professionals' awareness and attitudes regarding skin donation and skin banking. Methods: This cross-sectional survey was conducted at the All India Institute of Medical Sciences, Bhubaneswar, AIIMS, Odisha, between August 2020 to November 2020. A total of 124 health care practitioners from AIIMS, BBSR responded to the survey questions. It is divided into five sections: Social and economic data; Skin donation awareness survey, and skin bank attitude scale. Results: Less than half of health care professionals, 53.74 %, reported a lack of awareness of skin donation, and 56.16 per cent said lack of understanding of skin bank. The fair, positive relationship prevailed among skin donation awareness, and then either attitude (r=0.36, P=0.01), and a similar relationship existed between skin banking awareness and attitude (r=0.32, P=0.01). According to the report's findings, having a clear understanding of skin donation and skin banking leads to positive behaviours. Conclusion: In this review, health care professionals' awareness of skin donation and skin banking is average. Hospital and nursing administrators should be actively involved in education programmes to enhance nurses' education and increase awareness about skin donation and skin banking.


Study questionnaire
A self-administered, structured questionnaire is used to collect data from respondents. Sec A -assessed demographics comprised 11 items: age, gender, religion, healthcare professional, the field of work, education, awareness, source of news about skin donation, and vowed organ donation. Fifteen items and intended to explore a knowledge survey questionnaire skin donation and ten things related to skin banking knowledge, closed-ended questions offered with options choose in every item. Each move was recorded as one for a correct response and did not result in a zero score. In testing awareness on skin donation and skin banking, study participants who scored 80% or above were deemed to have a good understanding, 51 per cent to 79 per cent are rated relatively acceptable, and less than 50% were categorised as having inadequate knowledge. The fourth and fifth blocks measured health care professionals' views on skin donating and skin bank, with (> 51%) indicating a positive perception as well as (<50%) meaning an undesirable one. The study participants were approached on their workplaces, and the Google link was sent via Android devices.

Ethical and administrative issues
The AIIMS Institute Ethics Committee in Bhubaneswar, Odisha, has accepted the study, with reference number T/IM/NF/Nursing/20/63. Confirmed informed consent: After recruiting respondents, the investigator bided and affirmed their right to quit the poll without penalties, so their participation was voluntary.

Statistical Analysis
Data collected via Google forms were retrieved, encoded in MS Office Excel, then analysed using SPSS 22.0. The obtained data were analysed to use both descriptive and inferential tests. The descriptive statistics also included running frequencies and percentages. Karl Person correlation was used to estimate the relationship between knowledge information and perspective on skin donation and skin banking; the chi-square analysis was used to identify associations on demographics between computed knowledge and attitude scores. The statistical test was two-sided, and a P-value of.01 was deemed significant. These results are exposed to a mandatory test that is used to check for a 5% considerable relationship.

Tables 3 and 4
There was even a substantial difference in attitudes toward skin donation and skin banking amongst participants gender-based health professional and vowed organ donation. The mean attitude score for skin donation was 29.41 (SD,4.45) (Range 1-40), whereas the average attitude score for skin banking was 21.25 (SD,2.82) (Range1-32). There's no statistical difference in age, education, religion, awareness, or family history of skin donation between skin donation and skin bank views of healthcare professionals.

Knowledge and Attitude Correlation
The scatter diagrams in Figures 5 and 6 revealed a significant positive fair correlation between skin donation (r=0.36, p=0.01) and skin banking (r=0.32, p=0.01) outcome (knowledge & attitude). As per the study's findings, having a good understanding of skin donation and skin banking corresponds to positive attitudes among healthcare professionals.

V. DISCUSSION
According to the study's findings, barely half of the health care professionals, 51.6% and less than half (47.5%), had a somewhat better understanding of skin donation and skin banking. Nonetheless, as per a study in Nigeria (2014), awareness and attitude towards skin donation amongst nurses and doctors were high 78.3 per cent, and they were also aware that skin could be donated from the deceased. [3] Males 86.9 % were more passionate, increased acceptance of skin donation than women 72.5 % and all these findings coincided with Adnang's statement to varying degrees 68 per cent of women had considerably higher acceptance with skin donation over men 32 per cent. Half of the 51.6 per cent of healthcare providers were aware of skin donation from social networks; such results weren't in line with the study conducted by Michel et al., these results were emphasised, extremely good percentage Skin donation is acknowledged by 96.9 % of health care providers. [26] In India, the media is the key source of information exchange & influences people's perceptions. [27] The knowledge level among study respondents regarding skin donation 58.33 per cent and 7.4 per cent on skin banking was significant at the (P=0.03)level. The study's findings were supported by a survey carried in Riyadh (2017), which revealed, males 90.3 per cent were more knowledgeable than females with the notion of organ donation after death. They donated skin that used to rehabilitate burnt victims to conquer disfigurement. [10] The majority of study participants were more receptive towards skin donation (82.26 per cent), skin bank (83.88 per cent), and professional experience at intensive units, improving the overall view regarding skin donation and willingly giving processes. Human skin transplantation is a complex and sensitive matter because it concerns well being. These findings were recommended in Sweden's research. [28] According to the present study, physical ugliness following donating skin tissue is a major factor opposing skin donation. It was agreed by 64.52 per cent) of study participants and also (67.74 % ) of health care professionals that funeral service is unattainable. Only 16.13 % consented to motivate and assist their family and the public on skin donation. With both the study in Oyo state, similar findings were inconsistent. Almost the majority of them seem to be happy to give their skin, with only a few claiming deformities as that the reason for the reluctance to tissue donation [29]. In this study, healthcare professionals vowed for organ donation and positively perceived skin donation and skin bank. Some assume that simplifying instruction might influence attitudes. These findings are on par with Esezobor et al. Healthcare workers were likely to donate organs and educate the public about skin donation and skin banking benefits to aid burns and surgical, traumatic victims. [30] According to the present study results, only 22.58 % were ready to volunteer their skin after they die. In opposition to a recent study, Turkish found more than half % of healthcare workers were enrolled to become organ donors; however, 89.7 % of them declared a willingness to accept the transplant. [31]Finally, health care professionals with much more understanding about skin donation have a favourable and highly correlated attitude towards skin donation (r=0.36, p=0.01), implying that increased information about skin donation enhances their perspective on skin donation. In connection to the Taiwan study, an increase in educational standards and the training of the health care providers about various methods of donating organs and owing may create a reasonable opinion. [32] Bilgin has indeed highly recommended that lack of awareness on organ donation impacts willingness among health care workers.
[33] Religion is the most influential factor in skin and organ donation; it may advocate the public.
[34] As per the conclusions of the Serbian research, spiritual organisation' participation supported and encouraged organ donation

VI. RECOMMENDATIONS
The magnitude and demand for skin donation are high, and it is vital to highlight the importance of providing information on tissue transplantation at the institutional level. Health care professionals could act as mentors to promote awareness. Addressing teenage school and college students on skin donation and conducting school health program at the primary and secondary levels would influence the direction to behaviour and attitude among children, increasing the number of donors in the future. The survivor' awareness movies' sharing experiences could be used to raise awareness.
To draw attention and promote understanding of skin donation amongst this public, healthcare professionals would address immediate surroundings by giving a specific anecdote and commitment. Social support and understanding can be an incredible asset for dealing with the challenges of promoting skin donation.

VII. CONCLUSION
In this survey, health care professionals' familiarity with skin donation and skin banking is mediocre. These study results strongly suggest a need to deepen understanding during professional training and inform people through health talks and media. A continual educational campaign highlights the fact of organ and skin donation. In the process of skin donation and transplantation, healthcare professionals serve an important. The attitude toward skin donation can affect public opinion and also the choice to donate skins and other organs made by relatives of deceased donors. Hospital and nursing administrators should be actively involved in education programmes to enhance nurses' education and increase awareness about skin donation and skin banking.