TY - JOUR
T1 - Early wound excision within three days decreases risks of wound infection and death in burned patients
AU - De La Tejera, Giovanna
AU - Corona, Kassandra
AU - Efejuku, Tsola
AU - Keys, Phillip
AU - Joglar, Alejandro
AU - Villarreal, Elvia
AU - Gotewal, Sunny
AU - Wermine, Kendall
AU - Huang, Lyndon
AU - Golovko, George
AU - El Ayadi, Amina
AU - Palackic, Alen
AU - Wolf, Steven E.
AU - Song, Juquan
N1 - Publisher Copyright:
© 2023 Elsevier Ltd and International Society of Burns Injuries
PY - 2023/12
Y1 - 2023/12
N2 - Introduction: In lieu of limited studies on the timing of burn wound eschar excision for burns, a more comprehensive analysis is indicated to determine the effects of early wound excision following burns. This study aims to address the outcomes of early wound excision in burn patients. Methods: Data collection were from TriNetX research database. Three groups of burn patients were stratified by the number of days in which they received burn wound excision within 14 days of injury. Five outcomes were observed: death, wound infection, sepsis, myocardial contractile dysfunction, and blood transfusion. Risk and incidence of various health outcomes were compared between the groups after propensity-matching age, sex, ethnicity, race and burn size using a z-test with p < 0.05 considered significant. Results: We identified 6158 burn patients with wound excision within 14 days of injury, the majority of whom (60.1%) received burn wound excision between 0 and 3 days after burn. 72.5% of patients had burns covering less than 20% of total body surface area. After propensity matching, we found a significantly lower risk of mortality in those who received burn wound excision within the first three days (3.84%) as compared to 8–14 days after burn (6.09%) (p < 0.05). Moreover, we found a decreased risk of wound infection in patients with burn wound excision within 0–3 days (37.84%) compared to those 4–7 days (42.48%) (p < 0.05). No statistical difference was detected in propensity-matched groups for myocardial contractile dysfunction, blood transfusion, or sepsis. In addition, the risk of hypertrophic scaring significantly decreased when wound excision was performed within 0–3 days (22% within 0–3 days, 28% within 4–7 days, p < 0.05). Conclusion: Burn wound excision within 3 days of injury is beneficial when comparing to later treatment between 4 and 14 days, which results in a significantly lowered risk of mortality and infection in burn patient.
AB - Introduction: In lieu of limited studies on the timing of burn wound eschar excision for burns, a more comprehensive analysis is indicated to determine the effects of early wound excision following burns. This study aims to address the outcomes of early wound excision in burn patients. Methods: Data collection were from TriNetX research database. Three groups of burn patients were stratified by the number of days in which they received burn wound excision within 14 days of injury. Five outcomes were observed: death, wound infection, sepsis, myocardial contractile dysfunction, and blood transfusion. Risk and incidence of various health outcomes were compared between the groups after propensity-matching age, sex, ethnicity, race and burn size using a z-test with p < 0.05 considered significant. Results: We identified 6158 burn patients with wound excision within 14 days of injury, the majority of whom (60.1%) received burn wound excision between 0 and 3 days after burn. 72.5% of patients had burns covering less than 20% of total body surface area. After propensity matching, we found a significantly lower risk of mortality in those who received burn wound excision within the first three days (3.84%) as compared to 8–14 days after burn (6.09%) (p < 0.05). Moreover, we found a decreased risk of wound infection in patients with burn wound excision within 0–3 days (37.84%) compared to those 4–7 days (42.48%) (p < 0.05). No statistical difference was detected in propensity-matched groups for myocardial contractile dysfunction, blood transfusion, or sepsis. In addition, the risk of hypertrophic scaring significantly decreased when wound excision was performed within 0–3 days (22% within 0–3 days, 28% within 4–7 days, p < 0.05). Conclusion: Burn wound excision within 3 days of injury is beneficial when comparing to later treatment between 4 and 14 days, which results in a significantly lowered risk of mortality and infection in burn patient.
KW - Post-operative outcomes
KW - Retrospective study
KW - Time of intervention
KW - TriNetX database
UR - http://www.scopus.com/inward/record.url?scp=85164101663&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85164101663&partnerID=8YFLogxK
U2 - 10.1016/j.burns.2023.06.003
DO - 10.1016/j.burns.2023.06.003
M3 - Article
C2 - 37369613
AN - SCOPUS:85164101663
SN - 0305-4179
VL - 49
SP - 1816
EP - 1822
JO - Burns
JF - Burns
IS - 8
ER -