Study of the Influencing Factors and their Predictive Value of Skin Graft Take in Early Excision and Grafting in Severe Burns: A Prospective Study

Abstract

Abstract Background Burn injury is one of the most life-threatening traumas worldwide especially in developing countries. After severe burns, the patients suffer from loss of multiple functions of skin, such as fluid loss, and high infection rate with burn sepsis and septic shock. Objective To investigate the various factors that affect the survival rate of skin grafts in early excision and grafting procedures (from 3rd to 7th day after burn) in patients with severe burns. Patients and Methods This Prospective cohort study was done in Ain Shams University Burn Center attached to Plastic, burn and maxillofacial department during the period from May 2021 to May 2022. Results Analysis was performed on 75 individuals who had early burnt skin excised and early skin graft coverage. Two patient groups were analyzed, in the form of good skin graft take >70% in 45 patients, and poor skin graft take < 70% in 30 cases, based on the survival rate of the skin graft post operatively. Conclusion The univariate analysis and repeated measurement showed that burn intensity, the post-operative sepsis, the neutrophil lymphocytic ratio on day 3 (NLR3) in the poor skin graft take group were significantly higher than those in the good skin graft take group, while the estimated albumin levels in perioperative period and the estimated pre-albumin levels in perioperative period were higher in the good skin graft take group. Receiver operating characteristic curve showed that NLR3, the estimated albumin levels and pre-albumin levels in perioperative period had a good predictive value for the survival of skin grafts. The estimated albumin levels ≤3.18 gm/dl, estimated pre-albumin ≤23.9 mg/dl, and NLR3 ≥ 12 were independent risk factors for graft take in perioperative period.