Rate of healing in skin-grafted burn wounds

Skin grafting is a simple and common procedure for achieving wound closure. Despite its widespread use, there is little objective information about the outcomes of skin-grafted burn wounds. The purposes of this study were to determine the length of time it takes to achieve complete wound healing in split-thickness skin-grafted burn wounds and to identify factors that affect time to complete wound healing.

The authors prospectively collected information from January through September of 2003 on 52 consecutive patients. Time to complete wound healing was defined as the number of days from burn wound skin grafting until the wound was 100 percent epithelialized. Percentage of total body surface area burned, preoperative prealbumin level, sex, age, graft type, burn mechanism, cause of graft loss, and presence of hypergranulation tissue were assessed and correlated with time to complete wound healing.

The time to complete wound healing ranged from 2 to 75 days. Forty-six percent of skin grafts had 100 percent wound closure at postoperative day 7. No grafts were lost to infection. Factors that significantly affected time to complete wound healing were graft loss by seroma, preoperative prealbumin level, presence of hypergranulation tissue, and burns caused by hot solids.

The authors' results suggest that most patients will heal skin-grafted burn wounds within 2 weeks. Meticulous attention to prevention of seroma, hypergranulation tissue formation, and malnutrition might decrease time to complete wound healing. Factors thought to influence time to complete wound healing, such as total body surface area burned, sex, age, graft type, and infection, did not significantly affect the authors' patient group.