Abstract
Abstract Introduction Donor sites harvested for split-thickness skin grafts (STSG) are typically applied immediately to the intended recipient site. The size of a harvested donor site may delay discharge from the Burn Unit related donor site pain and healing. In September 2018, our burn center began to harvest donor sites early and banking the STSG for later use. In this paper, we evaluated the benefit and effectiveness of early donor site harvesting. Methods A retrospective review was performed to identify patients who underwent one homograft procedure followed by one autograft procedure that had donor sites harvested at the time of their homograft procedure and banked for later use (Group A). These patients were matched by TBSA and age to a patient that underwent a one homograft procedure followed by one autograft procedure that had a donor site harvested in their autograft procedure (Group B). TBSA, Total Length of Stay, and Length of Stay in terms of number of days per TBSA were reviewed for comparison. Results Since September 1, 2018, we have harvested STSG from 43 patients with their initial burn debridement and banked the STSG for their next surgery. The mean donor site size harvested early was 1520cm2. The average number of days the STSG was stored = 6.2 days. As seen in table 1, Group A has a larger mean TBSA and a shorter overall length of stay and lower number of days per TBSA. Both groups experienced graft loss in 2 patients that required regrafting. The graft loss in both groups was attributed to either poorly controlled diabetes or wound infection. The difference in length of stay is not statistically significant but is considered clinically and financially significant as the shorter length of stay is an average savings of $23662.80 in room and board charges. Conclusions Early harvesting of donor sites is successful and clinically effective. It is clinically safe to harvest and store STSG for delayed application. By harvesting donor sites early, patient discharge is not delayed due to an unhealed donor site which may be a financial savings for the patient and / or the institution. Applicability of Research to Practice Decreased of length of stay provides financial savings to the patient and the institution, as well as, decreasing possible complications.
Published Version
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