Early and Late Application of Skin Homograft in Management of Major Burn Patients: A Comparative Study

Our objective is to compare the effect of early and late application of skin homograft regarding complications and mortality rate. Burn is a type of physical trauma to skin or tissue. Burn can lead to loss of skin, resulting in deep, widespread skin wounds or even death. This prospective comparative study was done at the Plastic and Reconstructive Surgery Department of Menoufia University Hospitals from December 2017 to July 2020. It was conducted on 31 patients with major burns, classified into two main groups: the early homograft group (8 patients) and the late homograft group (23 patients). All studied patients and donors were subjected to a full history, general and local examination, and investigations such as complete blood counts (CBC), blood glucose level, kidney and liver function tests, electrolytes, and coagulation profile. Additionally, pre-operative preparation along with intra-operative and post-operative care were done. There was a significant decrease in temperature, HR, RR, SIRS score, TLC and K measurements, along with a decrease in rejection % and LOS (length of hospital stay) in the early homograft group compared to the late homograft group (p < 0.05 respectively). Additionally, there was a significant increase in albumin and Na measurements (p < 0.05, respectively). The use of homograft in major burn patients improved their overall condition by improving laboratory and respiratory data post-operatively. However, early usage of the homograft, especially in the first three days, improved laboratory data, SIRS score, percentage of rejection, and length of hospital stay.