The impact of skin grafts on the management of deep burns: Approaches and results in the treatment of third-degree burns

Deep burns are serious and complex injuries, leading to complete destruction of the skin and subjacent tissues, with risks of major complications. Treatment requires a multidisciplinary approach, with skin grafting playing a key role in restoring skin integrity and promoting healing. The aim of this study is to demonstrate the efficiency of skin grafting in the treatment of deep burns, and its impact on improving the management of burn patients. A retrospective study of 50 patients admitted for the management of deep burns, hospitalized in the plastic, reconstructive and burns surgery department of CHU Tanger-Tetouan-Al Hoceima, over a 12-month period. Patients were divided into two groups: 15 patients treated with skin grafting (30%) and 35 patients treated with directed wound healing (70%). The average age of the patients was 29 years. Men accounted for 60% of patients, with a predominance also in the graft group. Patient comorbidities included arterial hypertension (14%), psychiatric disorders (10%), diabetes (8%) and epilepsy (6%). In terms of burns, 56% were thermal by flame, 32% by liquid contact and 12% electrical burns. Burns mainly affected the upper limbs (60%) and trunk (46%). Concerning the burn extent, 62% of patients had a BSI ≥ 20%. Skin grafts were mainly performed after 21 days, with a majority of thin skin grafts (87%). Graft uptake was optimal in the majority of cases, and we observed a minimal rate of post-operative complications consisting of partial graft lysis and one case of infection. Finally, major complications were more frequent in the directed healing group, including retractile bridles (14%) and hypertrophic scars (20%), whereas grafted patients mainly presented dysesthesia (8%) and hypertrophic scars (6%). Skin grafting has an important role to play in restoring skin integrity and preventing complications, improving healing and having a significant functional and aesthetic impact.