Abstract | December 20, 2021

Early Versus Delayed Skin Excision for Burns: A Comparison of Outcomes

Presenting Author: Giovanna De La Tejera, BSA, University of Texas Medical Branch|Galveston|Texas

Co-Authors: Juquan Song, MD|Assistant Professor/Surgery|University of Texas Medical Branch at Galveston, Texas Kassandra Corona, BS|Medical Student/School of Medicine|University of Texas Medical Branch at Galveston, Texas Sunny Gotewal, BS|Medical Student/School of Medicine|University of Texas Medical Branch at Galveston, Texas Kendall Wermine, BS|Medical Student/School of Medicine|University of Texas Medical Branch at Galveston, Texas Phillip Keys, BS|Medical Student/School of Medicine|University of Texas Medical Branch at Galveston, Texas Tsola Efejuku, BSA|Medical Student/School of Medicine|University of Texas Medical Branch at Galveston, Texas Lyndon Huang, BA|Medical Student/School of Medicine|University of Texas Medical Branch at Galveston, Texas George Golovko, PhD|Assistant Professor/Pharmacology|University of Texas Medical Branch at Galveston, Texas Amina El Ayadi, PhD|Assistant Professor/Surgery|University of Texas Medical Branch at Galveston, Texas Steven E. Wolf, MD|Professor and Chief/Surgery|University of Texas Medical Branch at Galveston, Texas

Learning Objectives

  1. Upon completion of this lecture, learners should be better prepared to address the health benefits of early skin excision for burns and identify some of the underlying factors that lead to different health outcomes.

Introduction:
In lieu of outdated and limited patient studies on skin excisions for severe burns, a more comprehensive analysis is needed on the effects of early skin excision following burn injury. This retrospective study investigates differences in health outcomes for people who received early or delayed skin excision treatment after burn injuries. The study aims to address the health benefits of early skin excision for burns and identify underlying factors leading to different health outcomes.

Methods:
Data collection and analysis was performed using TriNetX, a national research database for healthcare. The study population includes males and females ages ranging from 0 to 90 years old who received skin excision treatment following burn injury. Groups were stratified by the number of days after injury in which they received a skin excision treatment. Five outcomes were observed: death, cardiac stress, skin infection, blood transfusion, and sepsis. Risk and incidence of various health outcomes were compared between the groups using a z-test with p<0.05 considered significant.

Results:
We identified 2,522 patients who received skin excision treatment between 0-3 days, 825 between 4-7 days, and 419 between 8-14 days following burn. We found a significant decrease in risk of skin infection and sepsis for skin excision 0-3 days after burn compared to 4-7 days (p<0.05). Additionally, frequency of blood transfusion significantly increased for those with excision 0-3 days after burn when compared to both 4-7 days and 8-14 days (p<0.05). However, we found no statistical difference in death, cardiac stress, skin infection, or sepsis between 0-3 and 8-14 days nor 4-7 and 8-14 days.

Conclusion:
Skin excision 0-3 days after burn injury results in a significantly lowered risk of negative health outcomes as compared to skin excision 4-7 days and 8-14 days after burn. Blood transfusion increased with early burn excision, which may be explained by the severity of injury.

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Posted in: Burn Medicine101
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