Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2012 Apr;47(2):119-124. Korean.
    Published online Apr 30, 2012.
    https://doi.org/10.4055/jkoa.2012.47.2.119
    Copyright © 2012 by The Korean Orthopaedic Association
    Original Article

    Analysis of Factors That Affect the Outcome of Skin Grafts

    Ki-Chan An, M.D., Jang-Seok Choi, M.D., Jung-Han Kim, M.D., and Dong-Min Kim, M.D.
      • Department of Orthopedic Surgery, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea.
    • Correspondence to: Jung-Han Kim, M.D. Department of Orthopedic Surgery, Busan Paik Hospital, College of Medicine, Inje University, 633-165, Gaegeum-dong, Busanjin-gu, Busan 614-735, Korea. TEL: +82-51-890-6129, FAX: +82-51-892-6619, Email: kimjunghan74@gmail.com
    Received April 08, 2010; Revised June 29, 2010; Accepted January 24, 2012.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Purpose

    This study aimed to investigate factors that affect the successful outcome of skin grafts.

    Materials and Methods

    One-hundred and one patients undergoing split-thickness skin grafts were reviewed between March 2000 and March 2008. The mean age of the patients was 39 years (16 to 67 years). The numbers of male and female patients were 63 (62.4%) and 38 (37.6%), respectively. The average follow up period was 8 weeks (2 to 23 weeks). For the analysis, patients were classified by patient factors and wound factors affecting the outcome of skin grafts. The criteria for the successful outcome of skin grafts were as follows: over 80% of skin ingestion rate, no exposure of subcutaneous tissue, no distinct signs of infection, and no need for reoperation. Also, statistical analysis was used to identify the correlation between each factor regarding the outcome of each skin graft.

    Results

    The preoperative serum levels of c-reactive protein (CRP) and white blood cell (WBC) were significantly correlated with the success of skin grafts (p<0.05). The cut-off value of WBC and CRP were 10.500×103/µl and 1.02 mg/dl, respectively. Each factor showed 27.6 and 9.5 times of association strength.

    Conclusion

    Among the various factors, the preoperative serum levels of CRP and WBC had significant correlations regarding the successful outcome of skin grafts. This result suggests that those levels can be objective indexes to predict the outcome of skin grafts.

    Keywords
    skin graft; correlation factors; correlation intensity

    Figures

    Figure 1
    Receiver operating characteristic (ROC) curve for prediction of skin graft outcomes. (A) ROC curve for prediction of graft failure by the level of CRP. Area under the curve was 0.760 (95% confidence interval: 0.666-0.838, p<0.001). (B) ROC curve for prediction of graft failure by the level of WBC. Area under the curve was 0.780 (95% confidence interval: 0.682-0.859, p<0.001). CRP, c-reactive protein; WBC, white blood cell.

    Figure 2
    Etiology of skin defects and the ratio of graft loss due to infection. In more than half of cases, the skin defects were caused by traumatic events. DM, diabetes mellitus.

    Tables

    Table 1
    Criteria for Defining a SSI

    Table 2
    Patient's Factors Associated with Skin Graft

    Table 3
    Wound Factors Associated Skin Graft

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    MeSH Terms
    C-Reactive Protein
    Eating
    Female
    Follow-Up Studies
    Humans
    Leukocytes
    Male
    Reoperation
    Skin
    Subcutaneous Tissue
    Transplants
    Metrics
    Share
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    Tables
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