Early use of allograft skin: are 3-day microbiologic cultures safe?

Background: Under the guidance of the American Association of Tissue Banks and the Food and Drug Administration, the use of allograft skin is safer than ever. In addition to the donor selection process and serology studies, current practice is to wait until 7 days of negative microbiologic cultures are completed before use. However, we have used 3 days of negative cultures in special cases as needed for clinical use. But how safe is this practice? Methods: Between 2002 and 2003, 735 allograft skin donors were authorized for exceptional release. Exceptional release forms were signed by surgeons to document knowledge of the 3-day microbiologic cultures. Results: Only three donors were re-called for positive cultures. The recall rate was 0.41%. Conclusions: The use of 3-day microbiologic cultures is 99.59% safe. Thus, the early use of allograft skin does not increase the chances of microbiologic contamination to patients.