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Split thickness skin graft meshing ratio indications and common practices.

Stahs Pripotnev1, Anthony Papp2

  • 1Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada.

Burns : Journal of the International Society for Burn Injuries
|June 13, 2017
PubMed
Summary

Larger burn size significantly influences Canadian surgeons to use higher skin graft meshing ratios. Burn location also impacts donor and recipient site selection in burn reconstruction.

Keywords:
BurnMeshingSkin graft

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Area of Science:

  • Plastic Surgery
  • Burn Reconstruction
  • Wound Healing

Background:

  • Split thickness skin grafting is a standard technique for burn wound resurfacing.
  • Meshing and expanding skin grafts facilitate reconstruction of large wounds from smaller donor sites.

Purpose of the Study:

  • To investigate factors influencing the use of higher skin graft meshing ratios in Canadian burn surgery.
  • To understand surgeon practices regarding skin graft meshing in burn reconstruction.

Main Methods:

  • Retrospective chart review of 210 burn patients (≥20% total body surface area) at Vancouver General Hospital (1998-2014).
  • Nationwide survey of Canadian plastic surgeons (CSPS) on burn surgery practices.
  • Data collected on patient demographics, burn characteristics, and meshing ratio decisions.

Main Results:

  • Patients receiving 3:1 or higher meshed grafts had significantly larger average total body surface area (TBSA) and full-thickness burn TBSA.
  • No significant differences in gender, age, or burn location between meshing ratio groups.
  • 60% of surveyed Canadian plastic surgeons use meshing ratios of 3:1 or higher; burn size and location influence this decision.

Conclusions:

  • Burn size is the primary determinant for employing higher skin graft meshing ratios in Canada.
  • Burn location influences the selection of donor and recipient sites for advanced meshing techniques.