The Effects of Hyperglycemia on Skin Graft Survival in the Burn Patient

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Abstract
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, Andrews K, Milner S, et al. The effects of hyperglycemia on skin graft survival in the burn patient. Ann Plast Surg 2000;45:629-632

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