Factors Affecting Success of Split-Thickness Skin Grafts in the Modern Burn Unit

Abstract

In the hands of an experienced burn surgeon, the recipient bed has no significant impact on the success rate of STSGs at 14 days postgrafting, except in those patients 18 years or younger, in which the mean STSG success rate was significantly greater on granulation tissue compared with fat. TBSA burned > 35%, age > 55 years, and the presence of diabetes mellitus continue to have an adverse impact on the success rate of STSGs at 14 days.

Rate of Healing in Skin-Grafted Burn Wounds

“…Although diabetes mellitus has been shown by many authors to cause delayed wound healing and poor skin graft take, we did not find a statistically significant correlation between the presence of diabetes and time to complete wound healing. [1][2][3][4]7,12 This may have been due to the aggressive treatment of hyperglycemia in our inpatients. We acknowledge that this nonsignificant finding could be related to the small number of cases in the series and the low incidence rate.…”

“…Although there is abundant information in the literature regarding skin graft healing and factors that contribute to major skin graft loss, most authors measure these outcomes at arbitrary time points in the healing process of the skin-grafted wounds, such as postoperative day 7 or postoperative day 14. [2][3][4][5] Until now, there has been no prospective information about the time it takes for skin-grafted burn wounds to become 100 percent epithelialized. This study provides that information as well as a description of the role played by risk factors previously known to contribute to graft loss or decreased graft take in time to complete wound healing.…”

“…In addition, factors that might affect the time to complete healing, such as infection, poor nutrition, hematoma, seroma, shear, burn size, and the presence of comorbid conditions, such as diabetes, have been not been well studied. 1,2 Studies that have reported the outcome of skingrafted wounds used an arbitrary endpoint of a few days to 2 weeks to measure the effects of variables such as graft type, infection, hematoma, shear, nutrition, and diabetic status on graft take. [2][3][4] Better information is needed to counsel our patients and improve our results.…”

Effective use of Biobrane as a temporary wound dressing prior to definitive split-skin graft in the treatment of severe burn: A retrospective analysis

“…Specific information regarding burn depth was also not reported on due to the variability in patient reporting methods. Underlying medical conditions which may affect graft-take such as diabetes mellitus [23] were not taken into account for this study.…”

Das Verbrennungstrauma –Teil 2

“…Gerade tangentiale Nekrosektomieverfahren stellen oft einen ausgedehnten Eingriff mit zum Teil erheblichem Blutverlust dar und "verbrauchen" rund 2 Erythrozytenkonzentrate/1000 cm 2 KOF (entspricht einer Fläche von 4-6% der Körperoberfläche; [11] [64]. Bei der epifaszialen Nekrosektomie kann mit blutungsreduzierenden Vasokonstriktiva unterspritzt werden; bei der tangentialen Nekrosektomie ist dies zu unterlassen, da es die Einschätzung der ausreichenden Debridementtiefe durch das Auftreten von punktuellen Blutungen verhindert.…”