The effects of hyperglycemia on skin graft survival in the burn patient.
The authors elected to determine the relative effects of hyperglycemia and/or elevated wound Gram-positive bacterial counts on success of skin graft survival in 74 burn patients. Results of serum glucose and quantitative wound biopsies on the day of admission and on postoperative day 4 were charted. Cases were separated into the following groups for analysis: normoglycemia plus normal bacterial counts, elevated bacterial counts only, hyperglycemia only, and hyperglycemia plus elevated bacterial counts. Successful graft "take" was defined as survival of 80% to 100% of the grafted area as assessed on postoperative day 4. Significant results included decreased incidence of graft take for groups with hyperglycemia only (62.5%), elevated bacterial counts only (63.3%), as well as hyperglycemia plus elevated bacterial counts (54.5%) when compared with the group with normoglycemia plus normal bacterial counts (92.8%; p = 0.020, p = 0.042, p = 0.012 respectively) for physiological parameters measured on postoperative day 4 only. Additionally, incidence of graft take was reassessed and found to be decreased significantly in groups with hyperglycemia (60.0%) vs. groups with normoglycemia (84.6%), regardless of Gram-positive bacterial counts (p = 0.034).
Mowlavi
A
A
Southern Illinois University, Institute for Plastic and Reconstructive Surgery, Springfield 62794, USA.
Andrews
K
K
Milner
S
S
Herndon
D N
DN
Heggers
J P
JP
D002056:Burns / Q000150:complications* / Q000382:microbiology / Q000601:surgery*; D016009:Chi-Square Distribution; D015169:Colony Count, Microbial; D006085:Graft Survival; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D016038:Skin Transplantation