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Baseline factors associated with split-thickness skin graft failure in burn patients: a retrospective observational analysis of a cohort of 69 burn patients

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Treatment of patients with a significant percentage of total body surface area of deep burns requires intensive care, including conservative therapy and debridement and split-thickness skin grafting surgery. Skin graft failure (SGF) is an absolute indication for regrafting and thus, it increases the number of reconstructive surgeries, prolongs the duration of hospital stay, and increases the risk of hospital-acquired infections. This study aims to identify factors associated with SGF, which can help quantify the risk of skin graft failure and eventually modify the disease course by pharmacological interventions.

Methods

A retrospective single centric longitudinal observational study of a cohort of adult burn patients admitted immediately after the injury to the Burn Intensive Care Unit was performed.

Results

Sixty-nine burn patients were included. Thirty-three patients (47.8%) underwent at least one regrafting due to skin graft failure. In simple regression analyses, we identified several baseline factors associated with skin graft failure. In multiple regression analyses, after controlling for confounding of percentage of total body surface area of deep burns, white blood cell count remained associated with skin graft failure.

Conclusions

Patients with higher baseline white blood cell count have higher risk of skin graft failure compared to those with the same percentage of total body surface area of deep burns but lower baseline white blood cell count.

Level of evidence: Level V, risk/prognostic

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Data Availability

The dataset used for the purpose of this study will be made available by the corresponding author upon request.

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Funding

This research did not receive specific funding but was performed as part of the employment of the authors at Pavol Jozef Safarik University, Hospital Agel Kosice-Saca, and L. Pasteur University Hospital.

Author information

Authors and Affiliations

  1. Department of Burns and Reconstructive Surgery, PJ Safarik University and Hospital Agel Kosice-Saca, Lucna 57, 040 15, Kosice-Saca, Slovakia

    Michala Gayova, Jan Babik & Peter Lengyel

  2. 1st Department of Surgery, PJ Safarik University in Kosice and L. Pasteur University Hospital, Trieda SNP 1, 040 11, Kosice, Slovakia

    Jana Katuchova

  3. 2nd Department of Internal Medicine, PJ Safarik University in Kosice and L. Pasteur University Hospital, Trieda SNP 1, 040 11, Kosice, Slovakia

    Jakub Gazda

Authors
  1. Michala Gayova
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  2. Jan Babik
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  3. Peter Lengyel
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  4. Jana Katuchova
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  5. Jakub Gazda
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Contributions

Michala Gayova: concept and design, data collection, drafting the article; Jan Babik: concept, design, critical review of the manuscript and approval of its final version; Peter Lengyel: critical review of the manuscript and approval of its final version; Jana Katuchova: critical review of the manuscript and approval of its final version; Jakub Gazda: concept, design, statistical analysis, critical review of the manuscript and approval of its final version. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jakub Gazda.

Ethics declarations

Ethics approval

The study protocol is in accordance with the 1964 Declaration of Helsinki and its later amendments and with good clinical practice principles. The study protocol was approved by the Ethical Committee of Hospital Agel Kosice-Saca, a.s. on February 2, 2022.

Patient consent

Ndue to the retrospective nature of data collection and the complete anonymity of the records, the committee waived the need for specific patients’ informed consent.

Conflict of interests

Michala Gayova, Jan Babik, Peter Lengyel, Jana Katuchova, and Jakub Gazda declare no conflict of interest.

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Gayova, M., Babik, J., Lengyel, P. et al. Baseline factors associated with split-thickness skin graft failure in burn patients: a retrospective observational analysis of a cohort of 69 burn patients. Eur J Plast Surg 46, 619–624 (2023). https://doi.org/10.1007/s00238-023-02049-1

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  • DOI: https://doi.org/10.1007/s00238-023-02049-1

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