Risk factors for skin graft loss in burn patients: A six-year cohort study in non-intensive care unit settings

The use of grafts in reconstructive surgeries for burn patients aims to speed up the healing process, improving recovery time. However, there are several factors related to the loss of these grafts, which negatively affect the recovery of these patients. This study analyzed the factors associated with graft loss in reconstructive burn surgeries, aiming to identify elements that could help reduce this outcome and consequently improve patient recovery. The study was conducted at the University Hospital of Londrina, Paraná, Brazil, involving 243 patients aged over 18 and older, admitted between 2018 and 2023. All participants underwent reconstructive surgery with skin grafts. Most patients were male, with a mean age of 41.3 years. Burns from open flames were the most prevalent. The average time from burn to graft was 13 days, and the average length of hospital stay was 17 days. Of the patients analyzed, 51 patients (21.1%) had graft loss, with key predictors including high ABSI scores, electrical burns, advanced age, and wound infection. In multivariable logistic regression, each additional hospital day was associated with 13% higher odds of graft loss (OR=1.13; 95% CI 1.07-1.20). The results provide quantitative evidence for the development of protocols focused on early wound optimization and reduction of preoperative hospitalization time, aiming to improve surgical outcomes and healthcare service efficiency.