Volume 32, Issue 1 (3-2025)
RJMS 2025, 32(1): 1-10 |
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Research code: 1402.07
Ethics code: IR.IUMS.REC.1402.07
Clinical trials code: 1402.07
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Shahrasbi M, Vaghardoost R, Alizadeh Otaghor H, Farokh Forghani S. Effectiveness of Skin Grafting in Diabetic Versus Non-Diabetic Patients with Second-Degree Burns. RJMS 2025; 32 (1) :1-10
URL: http://rjms.iums.ac.ir/article-1-9158-en.html
URL: http://rjms.iums.ac.ir/article-1-9158-en.html
Mohammadreza Shahrasbi1 
, Reza Vaghardoost *2 , Hamidreza Alizadeh Otaghor3 , Simak Farokh Forghani4
, Reza Vaghardoost *2 , Hamidreza Alizadeh Otaghor3 , Simak Farokh Forghani4
1- Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2- Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran ,Rezavaghar@yahoo.com
3- Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
4- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
2- Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran ,
3- Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
4- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
Abstract: (139 Views)
Background & Aims: Burn injuries remain a significant challenge in clinical practice, particularly among patients with comorbid conditions such as diabetes mellitus. These injuries often result in prolonged recovery periods, higher susceptibility to infection, and both functional and aesthetic complications that can affect the patient’s quality of life. Burns are not only a local injury but also trigger systemic responses that can complicate healing, especially in individuals with metabolic disorders. Delayed wound healing in diabetic patients is multifactorial. Vascular complications, such as microangiopathy and reduced capillary density, limit blood supply to injured tissues. Peripheral neuropathy can reduce protective sensation, increasing the risk of unnoticed injury and infection. Moreover, altered immune responses in diabetic individuals such as impaired neutrophil function and reduced cytokine signaling further compromise tissue repair and increase the likelihood of infection. These factors collectively contribute to slower healing, longer hospitalization, and greater risk of post-surgical complications following burn injuries. Skin grafting has emerged as a widely accepted intervention to accelerate wound closure and improve clinical outcomes in patients with burns. skin grafts, which use tissue harvested from the patient’s own body, are particularly advantageous because they minimize the risk of immune rejection and provide a biological barrier against infection. The procedure supports tissue regeneration and reduces scarring, helping restore both function and appearance. While skin grafting is generally effective in the overall population, its outcomes may be influenced by underlying conditions, particularly diabetes. Slower epithelialization, reduced angiogenesis, and impaired collagen deposition in diabetic patients can affect graft adherence and overall healing. Understanding these differences is essential for optimizing clinical protocols and improving patient-specific care. The present study aimed to compare the post-surgical outcomes of skin grafting in diabetic and non-diabetic patients with second-degree burns. By evaluating graft survival, wound healing progression, and complication rates, the study sought to determine whether diabetic patients achieve outcomes comparable to those of non-diabetic patients and to identify potential factors that may influence healing in this high-risk population.
Methods: A prospective cohort study was conducted at Shahid Motahari Hospital, including 56 patients diagnosed with second-degree burns. The participants were evenly divided into two groups: 28 diabetic patients and 28 non-diabetic patients. All patients underwent standardized skin grafting procedures performed by experienced surgical teams. Post-operative follow-up was conducted at three key time points: five days, one month, and three months after surgery. At each follow-up, clinical assessments were performed, focusing on graft adherence, wound closure, signs of infection, and overall tissue regeneration. Graft adherence was evaluated based on the degree of integration with surrounding tissue and the presence of necrosis or detachment. Wound closure was measured by the proportion of epithelialized area at each visit, while signs of infection including erythema, discharge, and systemic symptoms were carefully documented. Any complications or adverse events were managed according to established clinical protocols. Collected data were analyzed using SPSS software. Comparative statistical analyses were performed to determine differences between diabetic and non-diabetic patients in terms of graft survival, healing rate, and complication frequency.
Results: The study findings indicated that both diabetic and non-diabetic patients experienced generally favorable outcomes following skin grafting. By the one-month and three-month follow-ups, most diabetic patients had achieved satisfactory wound closure and tissue regeneration. Importantly, no significant differences were observed between the two groups in major post-operative complications such as graft rejection or infection. These findings suggest that, with careful perioperative management including glycemic control, wound care, and infection prevention diabetic patients can benefit from skin grafting similarly to non-diabetic patients. Close monitoring and timely interventions during the early post-operative period were essential in supporting graft survival and overall recovery.
Conclusion: Skin grafting is an effective treatment option for second-degree burns in both diabetic and non-diabetic individuals. Proper perioperative care, meticulous surgical technique, and vigilant post-operative monitoring, can mitigate initial delays in healing and support favorable outcomes. The study highlights the importance of individualized patient management, especially in high-risk populations such as those with diabetes mellitus. These findings provide strong evidence that diabetic patients should not be excluded from skin grafting solely due to concerns about impaired healing. With appropriate care, they can achieve outcomes comparable to non-diabetic patients, demonstrating the procedure’s broad applicability. Future research should focus on larger patient populations, longer follow-up periods, and additional factors such as nutritional status, medication effects, and comorbidity management. Such studies would help refine clinical protocols, improve patient-specific treatment strategies, and ultimately enhance outcomes for all burn patients, including those with metabolic disorders.
Methods: A prospective cohort study was conducted at Shahid Motahari Hospital, including 56 patients diagnosed with second-degree burns. The participants were evenly divided into two groups: 28 diabetic patients and 28 non-diabetic patients. All patients underwent standardized skin grafting procedures performed by experienced surgical teams. Post-operative follow-up was conducted at three key time points: five days, one month, and three months after surgery. At each follow-up, clinical assessments were performed, focusing on graft adherence, wound closure, signs of infection, and overall tissue regeneration. Graft adherence was evaluated based on the degree of integration with surrounding tissue and the presence of necrosis or detachment. Wound closure was measured by the proportion of epithelialized area at each visit, while signs of infection including erythema, discharge, and systemic symptoms were carefully documented. Any complications or adverse events were managed according to established clinical protocols. Collected data were analyzed using SPSS software. Comparative statistical analyses were performed to determine differences between diabetic and non-diabetic patients in terms of graft survival, healing rate, and complication frequency.
Results: The study findings indicated that both diabetic and non-diabetic patients experienced generally favorable outcomes following skin grafting. By the one-month and three-month follow-ups, most diabetic patients had achieved satisfactory wound closure and tissue regeneration. Importantly, no significant differences were observed between the two groups in major post-operative complications such as graft rejection or infection. These findings suggest that, with careful perioperative management including glycemic control, wound care, and infection prevention diabetic patients can benefit from skin grafting similarly to non-diabetic patients. Close monitoring and timely interventions during the early post-operative period were essential in supporting graft survival and overall recovery.
Conclusion: Skin grafting is an effective treatment option for second-degree burns in both diabetic and non-diabetic individuals. Proper perioperative care, meticulous surgical technique, and vigilant post-operative monitoring, can mitigate initial delays in healing and support favorable outcomes. The study highlights the importance of individualized patient management, especially in high-risk populations such as those with diabetes mellitus. These findings provide strong evidence that diabetic patients should not be excluded from skin grafting solely due to concerns about impaired healing. With appropriate care, they can achieve outcomes comparable to non-diabetic patients, demonstrating the procedure’s broad applicability. Future research should focus on larger patient populations, longer follow-up periods, and additional factors such as nutritional status, medication effects, and comorbidity management. Such studies would help refine clinical protocols, improve patient-specific treatment strategies, and ultimately enhance outcomes for all burn patients, including those with metabolic disorders.
Type of Study: Research |
Subject:
Plastic Surgery
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