Skin graft take rate among minor burns – A cohort study to investigate the effect of factors such as burn depth, burn size, and timing of the operation
Background: It has been known for decades that early excision of burns reduces morbidity and mortality. Early surgical excision and skin grafting has become the most important part of successful healing in burn management, especially in major burns. However, it is not entirely clear whether early ex...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Burns Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468912224000695 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832595359939952640 |
|---|---|
| author | Sinan Dogan Arina Mahmoud Ingrid Steinvall Elin Albertsson Elina Bergman Jamila Halimi Moustafa Elmasry |
| author_facet | Sinan Dogan Arina Mahmoud Ingrid Steinvall Elin Albertsson Elina Bergman Jamila Halimi Moustafa Elmasry |
| author_sort | Sinan Dogan |
| collection | DOAJ |
| description | Background: It has been known for decades that early excision of burns reduces morbidity and mortality. Early surgical excision and skin grafting has become the most important part of successful healing in burn management, especially in major burns. However, it is not entirely clear whether early excision and skin transplantation has the same advantages in smaller burns and there is no consensus on the timing of skin grafting in this group. The aim was to investigate the effect of timing and other factors for skin graft take rate among minor burns. Methods: This retrospective study included patients with thermal injury, a burn size smaller than 11 % total body surface area (TBSA), and who were treated with a skin graft operation. Take rate at the second dressing change after operation was used as main outcome, a cut-off of 95% take rate was for the multivariable logistic regression. Results: A total of 195 patients were included, median (IQR) age was 42 (9–68) years, 65 % were male, and median (IQR) area of deep burns was 2 (1–4) % of the body surface area (BSA). Multivariable regression showed that smaller area of deep burns and scalds (compared with flame and contact burns) were associated with a take rate of ≥ 95 %. Age, timing of the skin graft transplantation, and plasma C-reactive protein showed no independent effect on take rate. The regression model was significant but weak (ROC AUC 0.71, 95 % CI 0.62–0.79). Conclusion: Our results suggest that the extent and depth of the burn are the most important factors for skin graft take rate among minor burns, while timing of the transplantation is not associated with take rate for the skin graft. The advantageous effect of scalds may be interpreted to mean that scalds in general are more superficial than flame and contact burns, a difference that may not be detected by the use of a Lund and Browder chart. The conclusion is, however, tempered by the retrospective study design and the relatively low discriminatory power in our study. |
| format | Article |
| id | doaj-art-d791640dd9224473b32a85025f5cd4d3 |
| institution | Kabale University |
| issn | 2468-9122 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Burns Open |
| spelling | doaj-art-d791640dd9224473b32a85025f5cd4d32025-01-19T06:26:25ZengElsevierBurns Open2468-91222025-01-019100381Skin graft take rate among minor burns – A cohort study to investigate the effect of factors such as burn depth, burn size, and timing of the operationSinan Dogan0Arina Mahmoud1Ingrid Steinvall2Elin Albertsson3Elina Bergman4Jamila Halimi5Moustafa Elmasry6Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Corresponding author at: The Burn Centre, Linköping University Hospital, 58185 Linköping, Sweden.Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenDepartment of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenDepartment of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Surgery in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenDepartment of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenDepartment of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenDepartment of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenBackground: It has been known for decades that early excision of burns reduces morbidity and mortality. Early surgical excision and skin grafting has become the most important part of successful healing in burn management, especially in major burns. However, it is not entirely clear whether early excision and skin transplantation has the same advantages in smaller burns and there is no consensus on the timing of skin grafting in this group. The aim was to investigate the effect of timing and other factors for skin graft take rate among minor burns. Methods: This retrospective study included patients with thermal injury, a burn size smaller than 11 % total body surface area (TBSA), and who were treated with a skin graft operation. Take rate at the second dressing change after operation was used as main outcome, a cut-off of 95% take rate was for the multivariable logistic regression. Results: A total of 195 patients were included, median (IQR) age was 42 (9–68) years, 65 % were male, and median (IQR) area of deep burns was 2 (1–4) % of the body surface area (BSA). Multivariable regression showed that smaller area of deep burns and scalds (compared with flame and contact burns) were associated with a take rate of ≥ 95 %. Age, timing of the skin graft transplantation, and plasma C-reactive protein showed no independent effect on take rate. The regression model was significant but weak (ROC AUC 0.71, 95 % CI 0.62–0.79). Conclusion: Our results suggest that the extent and depth of the burn are the most important factors for skin graft take rate among minor burns, while timing of the transplantation is not associated with take rate for the skin graft. The advantageous effect of scalds may be interpreted to mean that scalds in general are more superficial than flame and contact burns, a difference that may not be detected by the use of a Lund and Browder chart. The conclusion is, however, tempered by the retrospective study design and the relatively low discriminatory power in our study.http://www.sciencedirect.com/science/article/pii/S2468912224000695BurnsSkin graft operationTake rateOutcomeSplit thickness skin graft |
| spellingShingle | Sinan Dogan Arina Mahmoud Ingrid Steinvall Elin Albertsson Elina Bergman Jamila Halimi Moustafa Elmasry Skin graft take rate among minor burns – A cohort study to investigate the effect of factors such as burn depth, burn size, and timing of the operation Burns Open Burns Skin graft operation Take rate Outcome Split thickness skin graft |
| title | Skin graft take rate among minor burns – A cohort study to investigate the effect of factors such as burn depth, burn size, and timing of the operation |
| title_full | Skin graft take rate among minor burns – A cohort study to investigate the effect of factors such as burn depth, burn size, and timing of the operation |
| title_fullStr | Skin graft take rate among minor burns – A cohort study to investigate the effect of factors such as burn depth, burn size, and timing of the operation |
| title_full_unstemmed | Skin graft take rate among minor burns – A cohort study to investigate the effect of factors such as burn depth, burn size, and timing of the operation |
| title_short | Skin graft take rate among minor burns – A cohort study to investigate the effect of factors such as burn depth, burn size, and timing of the operation |
| title_sort | skin graft take rate among minor burns a cohort study to investigate the effect of factors such as burn depth burn size and timing of the operation |
| topic | Burns Skin graft operation Take rate Outcome Split thickness skin graft |
| url | http://www.sciencedirect.com/science/article/pii/S2468912224000695 |
| work_keys_str_mv | AT sinandogan skingrafttakerateamongminorburnsacohortstudytoinvestigatetheeffectoffactorssuchasburndepthburnsizeandtimingoftheoperation AT arinamahmoud skingrafttakerateamongminorburnsacohortstudytoinvestigatetheeffectoffactorssuchasburndepthburnsizeandtimingoftheoperation AT ingridsteinvall skingrafttakerateamongminorburnsacohortstudytoinvestigatetheeffectoffactorssuchasburndepthburnsizeandtimingoftheoperation AT elinalbertsson skingrafttakerateamongminorburnsacohortstudytoinvestigatetheeffectoffactorssuchasburndepthburnsizeandtimingoftheoperation AT elinabergman skingrafttakerateamongminorburnsacohortstudytoinvestigatetheeffectoffactorssuchasburndepthburnsizeandtimingoftheoperation AT jamilahalimi skingrafttakerateamongminorburnsacohortstudytoinvestigatetheeffectoffactorssuchasburndepthburnsizeandtimingoftheoperation AT moustafaelmasry skingrafttakerateamongminorburnsacohortstudytoinvestigatetheeffectoffactorssuchasburndepthburnsizeandtimingoftheoperation |