Early Excision and Grafting Versus Delayed Skin Grafting in Extensive Burn Patients: A Retrospective Study at the National Burn Center in Morocco

Amine El Harti *

National Burn Center and Plastic Surgery Department, Faculté de Médecine et Pharmacie de Casablanca, CHU Ibn Rochd, Hassan 2 University, Morocco.

Sara Sabur

National Burn Center and Plastic Surgery Department, Faculté de Médecine et Pharmacie de Casablanca, CHU Ibn Rochd, Hassan 2 University, Morocco.

Marouane Habla

National Burn Center and Plastic Surgery Department, Faculté de Médecine et Pharmacie de Casablanca, CHU Ibn Rochd, Hassan 2 University, Morocco.

Ahlam Youssfi

National Burn Center and Plastic Surgery Department, Faculté de Médecine et Pharmacie de Casablanca, CHU Ibn Rochd, Hassan 2 University, Morocco.

Sarah Karti

National Burn Center and Plastic Surgery Department, Faculté de Médecine et Pharmacie de Casablanca, CHU Ibn Rochd, Hassan 2 University, Morocco.

Mounia Diouri

National Burn Center and Plastic Surgery Department, Faculté de Médecine et Pharmacie de Casablanca, CHU Ibn Rochd, Hassan 2 University, Morocco.

*Author to whom correspondence should be addressed.


Abstract

Severe burns pose significant challenges to patients and healthcare providers due to their high mortality rate and prolonged hospital stay. This article aims to investigate the effects of early excision and skin grafting compared to conservative management with delayed skin grafting on reducing mortality and hospitalization duration.

We conducted a retrospective study to evaluate the outcomes of acute burn patients with extensive burns admitted to the National Burn Center in Morocco from January 2017 to December 2022, with a total body surface area (TBSA) of a burn between 10% to 60%.

The findings suggest that early excision and skin grafting significantly decrease the mortality rate and hospital stay in extensive burn patients. However, careful patient selection, meticulous surgical techniques, and appropriate postoperative care remain crucial for achieving optimal outcomes.

Keywords: Burn management, early excision, severe burns, skin grafting


How to Cite

Harti , A. E., Sabur , S., Habla , M., Youssfi , A., Karti , S., & Diouri , M. (2023). Early Excision and Grafting Versus Delayed Skin Grafting in Extensive Burn Patients: A Retrospective Study at the National Burn Center in Morocco. Journal of Advances in Medicine and Medical Research, 35(21), 39–42. https://doi.org/10.9734/jammr/2023/v35i215208

Downloads

Download data is not yet available.

References

Schaefer TJ, Tannan SC. Thermal Burns. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.

Hayashi K, Sasabuchi Y, Matsui H, Nakajima M, Otawara M, Ohbe H, Fushimi K, Ono K, Yasunaga H. Does early excision or skin grafting of severe burns improve prognosis? A retrospective cohort study. Burns. 2023;49(3):554-561.

Syarif AN, Afira F, Wardhana A, Ramadhan A. Analyzing Mortality and the Effect of Early Excision As A Preliminary Treatment Of Acute Burn Patients In A Limited Resource Setting Using LA50 As An Outcome Measurement. Ann Burns Fire Disasters. 2022 30;35(2):125-136.

Ong YS, Samuel M , Song C . Meta-analysis of early excision of burns Burns. 2006;32:145-150,

DOI:10.1016/j.burns.2005.09.005.

Janžekovič Z. A new concept in the early excision and immediate grafting of burns. J Trauma. 1970;10:1103-1108,

DOI:10.1097/00005373-197012000-00001

Hettiaratchy S, Papini R. Initial management of a major burn: I–overview. BMJ. 2004;328:1555-1557,

DOI:10.1136/bmj.328.7455.1555.

Snell JA, Loh NH, Mahambrey T , Shokrollahi K . Clinical review: The critical care management of the burn patient. Crit Care. 2013;17:241

1186/cc12706.

Goswami P, Sahu S, Singodia P, Kumar M, Tudu T, Kumar A, Sinha PK. Early Excision and Grafting in Burns: An experience in a Tertiary Care Industrial Hospital of Eastern India. Indian J Plast Surg. 2019;52(3):337-342.

Gallaher JR, Mjuweni S , Shah M , Bruce A , Charles AG . Timing of early excision and grafting following burn in sub-Saharan Cairns Africa. Burns J Int Soc Burn Inj. 2015;41:1353-1359,

DOI:10.1016/j.burns.2015.02.011.

Ahuja RB, Bhattacharya S. Burns in the developing world and burn disasters. BMJ. 2004;329:447-449,

DOI:10.1136/bmj.329.7463.447.

Toussaint J, Chung WT, Mc Clain S, Raut V, Singer AJ. optimal timing for early excision in a deep partial thickness porcine burn model. J Burn Care Res. 2017;38(1):e352-e358.

Puri V, Khare NA, Chandramouli MV, Shende N, Bharadwaj S. Comparative Analysis of Early Excision and Grafting vs Delayed Grafting in Burn Patients in a Developing Country. J Burn Care Res. 2016;37(5):278-82.

Keshavarzi A, Ayaz M, Dehghankhalili M. Ultra-Early versus Early Excision and Grafting for Thermal Burns up to 60% Total Body Surface Area; A Historical Cohort Study. Bull Emerg Trauma. 2016;4(4):197-201.

Mohammadi AA, Mohammadi S. Early excision and grafting (EE&G): Opportunity or threat?. Burns. 2017;43(6):1358-1359.

Barret JP, Herndon DN. Effects of burn wound excision on bacterial colonization and invasion. Plast Reconstr Surg. 2003;111(2):744–50. Discussion 51-2.

Khadjibayev AM, Fayazov AD, Djabriyev DA, Kamilov UR. Surgical treatment of deep burns. Ann Burns Fire Disasters. 2008;21(3):150–2.

Pavoni V, Gianesello L, Paparella L, Buoninsegni LT, Barboni E. Outcome predictors and quality of life of severe burn patients admitted to intensive care unit. Scand J Trauma Resusc Emerg Med. 2010;18:24.

Ayaz M, Keshavarzi A, Bahadoran H, Arasteh P, Moslemi S. comparison of the results of early excision and grafting between children and adults; A prospective comparative study. Bull Emerg Trauma. 2017;5(3):179-183.

Mohammadi AA, Mohammadi S. Avoiding overzealous excision of superficial burn and full excision of deep areas are two equally important prerequisites for successful early excision and grafting (EE&G). Burns. 2018;44(1):230-231.

Xiao-Wu W, Herndon DN, Spies M, Sanford AP, Wolf SE. Effects of delayed wound excision and grafting in severely burned children. Arch Surg. 2002;137(9):1049–54.