Graft Uptake in Burns: Clinical Audit and the Impact of Perioperative Interventions

Correspondence: Vijay Kumar (E-mail: [e-mail])

Abstract

Background Graft uptake is a key indicator of successful burn wound management. Ongoing clinical audit supports the evaluation of care standards and identification of areas for improvement. To optimize graft take, multiple targeted interventions can be implemented throughout the perioperative period.

Aims This audit aimed to assess rates of graft uptake following split-thickness skin grafting in burns at (department/institution) over a 6-month period (January–June 2024), evaluate factors affecting graft success, and measure the impact of specific quality improvement interventions. Our standard was ≥90% graft uptake in at least 80% of cases.

Methodology Fifty-six burn patients (mean age 32 years; 68% male; mean TBSA 14%) underwent standardized split-thickness skin grafting. Interventions included rigorous infection prevention and control (aseptic technique, perioperative antibiotics, wound bed optimization), meticulous hemostasis and secure graft fixation, careful patient positioning and immobilization, standardized postoperative wound care, nutritional optimization, and early physiotherapy. A multidisciplinary approach facilitated prompt identification and management of complications. Assessment of graft uptake occurred at day 7 and on discharge; root cause analysis was performed for cases with <90% uptake.

Results Mean graft uptake at day 7 was 93%. Complete (>95%) uptake occurred in 79% of cases, partial uptake (75–95%) in 18%, and <75% uptake in 3%. Infections (6 cases), hematoma (3), and graft shear (3) were the predominant causes of suboptimal uptake. Following implementation of targeted interventions—especially strict infection control, improved hemostasis, and enhanced patient education—the proportion of patients achieving ≥90% uptake increased from 76% to 83% in the latter half of the audit. No technical graft failures or donor site complications were noted.

Keywords: burn graft uptake, STSG, audit, infection control

Publikationsverlauf

Artikel online veröffentlicht:
10. November 2025