title: Does the type of skin replacement surgery influence the rate of infection in acute burn injured patients?
abstract: BACKGROUND
  Infection is a major cause of morbidity and mortality following burn. Early debridement and wound closure minimize the risk of infection. This study aimed to examine the association of surgical modalities with burn wound infection (BWI) rate, graft loss and length of stay (LOS) outcome.
  
  
  METHODS
  This study is a retrospective analysis of all patients undergoing surgical intervention at the Royal Perth Hospital between 2004 and 2011. Multivariable regression analyses were used to predict the impact of burn and patient factors on the outcomes.
  
  
  RESULTS
  Seven hundred seventy patients were eligible for inclusion with 74.8% males and a mean total body surface area (TBSA) burnt of 7.9% (range 1.0-75). Sixty-seven patients (8.7%) had positive post-operative swabs indicating potential wound infection. Age and TBSA significantly increased the risk of BWI (confirmed by quantitative swab). Positive microbiology was not associated with surgery type. Age, TBSA, diabetes and surgical modalities had significant influence on LOS in hospital. Only TBSA was an independent predictor of graft loss.
  
  
  CONCLUSIONS
  Age, TBSA and diabetes were associated with poorer outcomes after burn. Surgery type was not associated independently with the risk of infection.
authors.affiliation: Burns Service of Western Australia, Royal Perth Hospital, Fiona Wood Foundation of Western, Australia; School of Medicine, University of Notre Dame, Fremantle, Australia.
authors.forename: Jae H
authors.initials: JH
authors.lastname: Park
authors.forename: Katrina M
authors.initials: KM
authors.lastname: Heggie
authors.forename: Dale W
authors.initials: DW
authors.lastname: Edgar
authors.forename: Max K
authors.initials: MK
authors.lastname: Bulsara
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Wood
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D002056:Burns / Q000150:complications / Q000601:surgery*; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016038:Skin Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D014946:Wound Infection / Q000453:epidemiology* / Q000382:microbiology
keywords: Acute burns; Infection; Surgery