1. DF – Deep-frozen FD – Freeze-dried Tissue/Bone Bank Types of Tissue/Bone AllograftNational Tissue Bank, USM No. (pieces) DF Knee slices0 DF Femur5 DF Femoral head75 DF Humerus0 DF Tibia4 DF Radius1 DF Ulna0 FD Cancellous37 FD Cortical0 FD Cortico-cancellous0 Patella4 Other tendon / fascia / cartilage1 Amniotic membranes379 TOTAL506 Table 7.1.1: Types Of Tissue/Bone Allografts Supplied by National Tissue Bank, USM in 2006

2. Tissue/Bone Bank National Tissue Bank, USM No. (pieces) MOH Hospital Selayang3 Hospital Seremban1 Hospital Sultanah Aminah, Johor Bahru11 Hospital Pantai Air Keroh, Melaka4 Hospital Pulau Pinang7 Hospital Ipoh9 Hospital Alor Setar6 Hospital Umum Sarawak10 Hospital Kuala Terengganu2 Hospital Kemaman10 Hospital Tengku Ampuan Afzan, Kuantan2 Hospital Raja Perempuan Zainab II, Kota Bharu1 Queen Elizabeth Hospital, Sabah12 TOTAL78 University HUKM3 HUSM29 TOTAL32 Private and other sectors Antal Rastu Sdn Bhd2 Kota Bharu Medical Centre2 Kota Medical Centre, Melaka1 Lam Wah Ee Penang3 Pantai Medical Centre, Air Keroh1 Stryker6 Sunway Medical Centre1 TOTAL16 Table 7.1.2: Hospitals/Other Sectors Using Bone Allografts in 2006

3. Tissue/Bone Bank National Tissue Bank, USM No. (pieces) MOH Hospital Kuala Lumpur13 Hospital Selayang1 Hospital Sultanah Aminah, Johor Bahru200 Hospital Melaka10 Hospital Alor Setar2 Hospital Teluk Intan1 Hospital Tengku Ampuan Afzan, Kuantan7 Hospital Queen Elizabeth4 TOTAL238 University HUSM8 UMMC4 HUKM2 TOTAL14 Private and other sectors Gleneagles Medical Centre, Penang8 Hospital Pakar Johor100 Sri Kota Medical Centre, Klang4 Pusat Rawatan Islam Al-Zahirah, Bangi Selangor10 Hospital Tawakal, Kuala Lumpur4 Putra Medical Centre1 TOTAL127 Table 7.1.3: Hospitals/Other Sectors Using Amniotic Membranes in 2006

4. Centre 200420052006 TOTAL No. Orthopaedics Department Orthopaedics Department, HUSM17210 Department of Orthopaedics Surgery, UMMC1001 Institute of Orthopaedic & Traumatology, HKL2002 Department of Orthopaedics, Hospital Ipoh0101 Department of Orthopaedics, Hospital Kota Bharu93012 Orthopaedic Department, Hospital Umum Sarawak1012 Orthopaedics Department, Hospital Sultanah Aminah, Johor Bahru0101 Wan Orthopaedic, Trauma & Sports Injury Centre (WOTSIC), Seremban Specialist Hospital0022 Orthopaedics Department, Hospital Island, Penang0101 Orthopaedics Department, Hospital Fatimah, Ipoh0303 Orthopaedics Department, Kota Bharu Medical Centre0022 Normah Medical Specialist Centre, Kuching0101 Spine Unit, HUSM0011 Ophthalmology Department Ophthalmology Dept, Hospital Tengku Ampuan Rahimah, Klang1102 Ophthalmology Dept, Hospital Tengku Ampuan Afzan, Kuantan1102 Ophthalmology Department, Hospital Teluk Intan0011 Ophthalmology Department, HKL0023 Ophthalmology Department, Hospital Alor Setar0011 Ophthalmology Department, Sri Kota Medical Centre, Klang0101 Ophthalmology Department, HUSM0011 Others Department Maxillofacial Surgery, HUSM1102 Timberland Medical Centre0101 Sri Kota Medical Centre, Klang0011 TOTAL17223574 Table 7.2.1: Distribution of Reporting Centre by Year

5. Gender 200420052006TOTAL No.% % % % Male953104527774662 Female84712558232838 TOTAL17100221003510074100 Ethnic Group 200420052006TOTAL No.% % % % Malay1165146426745169 Chinese3185237201520 Indian16151334 Bumiputra Sabah00000000 Bumiputra Sarawak16000011 Others16291345 TOTAL17100221003510074100 Table 7.3.1: Distribution of Patients by Gender Table 7.3.2: Distribution of Patients by Ethnic Group

6. Age Group 200420052006TOTAL No.% % % % 0-9001541157 10-191662726912 20-3995362716463142 40-595293148231622 ≥60165234111014 Missing16151334 TOTAL17100221003510074100 Mean35343635 SD132219 Median33263533 Min15700 Max6075 Table 7.3.3: Distribution of Patients by Age Group

7. Diagnosis 200420052006TOTAL No.% % % % Congenital deformity16001323 Infection00003934 Trauma529156171216 Degenerative disease16290034 Tumour-benign529418131014 Tumour-malignant006271379 Burn00152634 Scald00001311 Sports injury00150011 Failed primary surgery16291345 Ophthalmological000016461622 Others5293146171419 TOTAL17100221003510074100 Table 7.3.4: Distribution of Patients by Diagnosis Warranting Tissue Graft Transplantation

8. Name Tissue Bank 200420052006TOTAL No.% % % % Tissue Bank, USM1376188231896284 Bone Bank, UMMC16000011 Bone Bank, HKL318000034 Eucara Pharmaceutical00002623 Osteo Tech Inc00150011 Missing003142657 TOTAL17100221003510074100 Origin of Tissue Graft 200420052006TOTAL No.% % % % Local17100156831896385 Imported003142657 Missing004182668 TOTAL17100221003510074100 Table 7.4.1: Distribution of Patients According to Tissue Provider Table 7.4.2: Distribution of Patients by Origin of Tissue Graft

9. Tissue Graft TypeTissue Graft Types 200420052006TOTAL No.% % % % Deep frozen tissues 95314645142838 Femur333321006 Femoral Head22212862401657 Humerus0017360414 Tibia11117120311 Radius22253600725 Freeze dried (Lyophilised) 63541829833953 Amniotic membranes23337525863077 Not Available212290045 Missing00291334 TOTAL17100221003510074100 Table 7.4.3: Distribution of Patients by Tissue Graft Type

10. Type Graft Sterilisation 200420052006TOTAL No.% % % % Gamma Irradiation1694836002432 Glycerol00002623 Sterile Freeze Dried Bone00150011 Missing16135933944764 TOTAL17100221003510074100 Mode of Transport Storage to recipient hospital 200420052006TOTAL No.% % % % By Flight16152645 By Courier21231424692939 By Hand424836131318 Dry Ice Box52941800912 Sterile package00002623 Missing529627617 23 TOTAL17100221003510074100 Table 7.4.4: Distribution of Type of Sterilisation of the Graft Table 7.4.5: Distribution of Mode of Transport Storage to Recipient Hospital during Transportation

11. Temperature of storage during transportation ( o C) 200420052006TOTAL No.% % % % -80212000023 -4000150011 -2042441800811 -100062726811 0212000023 3700002623 Missing953115031895169 TOTAL17100221003510074100 Table 7.4.6: Distribution of Temperature of Storage during Transportation

12. Mode of storage in recipient hospital 200420052006TOTAL No.% % % % Refrigerator001525712635 Deep freezer-20 degree Celsius003142657 Deep freezer-40 degree Celsius16290034 Deep freezer-80 degree Celsius3184 13811 Glycerol00153945 Room temperature00151323 Others1271523261926 Not available16000011 Missing005231368 TOTAL17100221003510074100 Table 7.5.1: Distribution of Mode of Storage in Recipient Hospitals

13. Additional tissue usage (composite graft) 200420052006TOTAL No.% % % % No635125532915068 Yes953732131723 Not available212150034 Missing00292645 TOTAL17100221003510074100 Type of additional tissue used (composite graft) 200420052006TOTAL No.% % % % Autografts778343001059 Allografts1112291100424 Others11111400212 Missing001140016 TOTAL91007 1 17100 Table 7.5.2: Distribution of Additional Tissue Usage (Composite Graft) Table 7.5.3: Distribution of Type of Additional Tissue Used (Composite Graft)

14. Presence of pre operative infection at implant site 200420052006TOTAL No.% % % % No1588219531896791 Yes000041145 Not Available212000023 Missing00150011 TOTAL17100221003510074100 Pre implant graft culture swab 200420052006TOTAL No.% % % % No1588167317494865 Yes00150011 Not Available21200617811 Missing0052312341723 TOTAL17100221003510074100 Table 7.5.4: Distribution of Presence of Pre Operative Infection at Implant Site Table 7.5.5: Distribution of Pre Implant Graft Culture Swab

15. Type of infection of pre implant graft 200420052006TOTAL No.% % % % Cytomegalovirus001100001 Proteus00000000 TOTAL001100001 Grafts soaked in antibiotics prior to transplantation 200420052006TOTAL No.% % % % No84752328804155 Yes74116736172939 Not Available212001334 Missing00150011 TOTAL17100221003510074100 Table 7.5.6: Distribution of Type of Infection of Pre Implant Graft Table 7.5.7: Distribution of Grafts Soaked in Antibiotics Prior to Transplantation

16. Antibiotics used to soak the grafts in prior to transplantation 200420052006TOTAL No.% % % % Ceftriazone4579563501655 Gentamycin3434253501034 Ceftriazone and Gentamycin00000000 Vancomycin, Postome iodine00160013 Povidone iodine, Ceftriazone00160013 Missing00160013 TOTAL7100161006 29100 Systemic antibiotics prior to transplantation 200420052006TOTAL No.% % % % No42431426743345 Yes127117779263851 Not Available16000011 Missing00290023 TOTAL17100221003510074100 Table 7.5.8: Distribution of Antibiotics Used to Soak the Grafts in Prior to Transplantation Table 7.5.9: Distribution of Patients by Systemic Antibiotics Given Prior to Transplantation

17. Type of systemic antibiotics given to patient prior to transplantation 200420052006TOTAL No.% % % % Cefeperazone21721200411 Ceftriazone000011113 Cefuroxine7587414441847 Ciproflaxacin002120025 Chloramphenicol000011113 Metronidazole18160025 Ceftazidine000011113 Ceftriazone/Imipenam217212222616 Ampicillin/Sulbactam002120025 Missing00160013 TOTAL12100171009 38100 Table 7.5.10: Distribution of Patients by Type of Systemic Antibiotics Given Prior to Transplantation