An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit
Objectives: Skin graft failure is a recognised complication in the treatment of major burns. Little research to date has analysed the impact of the complex physiological management of burns patients on the success of skin grafting. We analysed surgical and anaesthetic variables to identify factors c...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2016-04-01
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| Series: | Scars, Burns & Healing |
| Online Access: | https://doi.org/10.1177/2059513116642089 |
| _version_ | 1818112607470485504 |
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| author | Catherine E Isitt Kayleigh A McCloskey Alvaro Caballo Pranev Sharma Andrew Williams Jorge Leon-Villapalos Marcela P Vizcaychipi |
| author_facet | Catherine E Isitt Kayleigh A McCloskey Alvaro Caballo Pranev Sharma Andrew Williams Jorge Leon-Villapalos Marcela P Vizcaychipi |
| author_sort | Catherine E Isitt |
| collection | DOAJ |
| description | Objectives: Skin graft failure is a recognised complication in the treatment of major burns. Little research to date has analysed the impact of the complex physiological management of burns patients on the success of skin grafting. We analysed surgical and anaesthetic variables to identify factors contributing to graft failure. Methods: Inclusion criteria were admission to our Burns Intensive Care Unit (BICU) between January 2009 and October 2013 with a major burn. After exclusion for death before hospital discharge or prior skin graft at a different hospital, 35 patients remained and were divided into those with successful autografts (n=16) and those with a failed autograft (n=19). For the purposes of this study, we defined poor autograft viability as requiring at least one additional skin graft to the same site. Logistic regression of variables was performed using SPSS (Version 22.0 IBMTM). Results: Age, Sex, %Total Burn Surface Area or Belgian Outcome Burns Injury score did not significantly differ between groups. No differences were found in any surgical factor at logistic regression (graft site, harvest site, infection etc.). When all operations were analysed, the use of colloids was found to be significantly associated with graft failure (p=0.035, CI 95%) and this remained significant when only split thickness skin grafts (STSGs) and debridement operations were included (p=0.034, CI 95%). No differences were found in crystalloid use, intraoperative temperature, pre-operative haemoglobin and blood products or vasopressor use. Conclusions: This analysis highlights an independent association between colloids and graft failure which has not been previously documented. |
| first_indexed | 2024-12-11T03:21:38Z |
| format | Article |
| id | doaj.art-6619d1f58a15455aabbcb5ed057e9843 |
| institution | Directory Open Access Journal |
| issn | 2059-5131 |
| language | English |
| last_indexed | 2024-12-11T03:21:38Z |
| publishDate | 2016-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Scars, Burns & Healing |
| spelling | doaj.art-6619d1f58a15455aabbcb5ed057e98432022-12-22T01:22:37ZengSAGE PublishingScars, Burns & Healing2059-51312016-04-01210.1177/2059513116642089An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care UnitCatherine E Isitt0Kayleigh A McCloskey1Alvaro Caballo2Pranev Sharma3Andrew Williams4Jorge Leon-Villapalos5Marcela P Vizcaychipi6Department of Anaesthetics and Intensive Care, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UKDepartment of Anaesthetics and Intensive Care, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UKDepartment of Plastics and Burns Surgery, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UKDepartment of Anaesthetics and Intensive Care, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UKDepartment of Plastics and Burns Surgery, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UKDepartment of Plastics and Burns Surgery, Chelsea and Westminster Hospital NHS Trust, London SW10 9NH, UKFaculty of Medicine, Imperial College London, London SW7 2AZ, UKObjectives: Skin graft failure is a recognised complication in the treatment of major burns. Little research to date has analysed the impact of the complex physiological management of burns patients on the success of skin grafting. We analysed surgical and anaesthetic variables to identify factors contributing to graft failure. Methods: Inclusion criteria were admission to our Burns Intensive Care Unit (BICU) between January 2009 and October 2013 with a major burn. After exclusion for death before hospital discharge or prior skin graft at a different hospital, 35 patients remained and were divided into those with successful autografts (n=16) and those with a failed autograft (n=19). For the purposes of this study, we defined poor autograft viability as requiring at least one additional skin graft to the same site. Logistic regression of variables was performed using SPSS (Version 22.0 IBMTM). Results: Age, Sex, %Total Burn Surface Area or Belgian Outcome Burns Injury score did not significantly differ between groups. No differences were found in any surgical factor at logistic regression (graft site, harvest site, infection etc.). When all operations were analysed, the use of colloids was found to be significantly associated with graft failure (p=0.035, CI 95%) and this remained significant when only split thickness skin grafts (STSGs) and debridement operations were included (p=0.034, CI 95%). No differences were found in crystalloid use, intraoperative temperature, pre-operative haemoglobin and blood products or vasopressor use. Conclusions: This analysis highlights an independent association between colloids and graft failure which has not been previously documented.https://doi.org/10.1177/2059513116642089 |
| spellingShingle | Catherine E Isitt Kayleigh A McCloskey Alvaro Caballo Pranev Sharma Andrew Williams Jorge Leon-Villapalos Marcela P Vizcaychipi An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit Scars, Burns & Healing |
| title | An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit |
| title_full | An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit |
| title_fullStr | An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit |
| title_full_unstemmed | An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit |
| title_short | An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit |
| title_sort | analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a burns intensive care unit |
| url | https://doi.org/10.1177/2059513116642089 |
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