The effects of hyperglycemia on skin graft survival in the burn patient

The authors elected to determine the relative effects of hyperglycemia and/ or elevated wound Gram-positive bacterial counts on success of skin graft s urvival in 74 burn patients. Results of serum glucose and quantitative woun d biopsies on the day of admission and on postoperative day 4 were charted. Cases were separated into the following groups for analysis: normoglycemia plus normal bacterial counts, elevated bacterial counts only, hyperglycemi a only, and hyperglycemia plus elevated bacterial counts. Successful graft "take" was defined as survival of 80% to 100% of the grafted area as assess ed on postoperative day 4. Significant results included decreased incidence of graft take for groups with hyperglycemia only (62.5%), elevated bacteri al counts only (63.3%), as well as hyperglycemia plus elevated bacterial co unts (54.5%) when compared with the group with normoglycemia plus normal ba cterial counts (92.8%; p = 0.020, p = 0.042, p = 0.012 respectively) for ph ysiological parameters measured on postoperative day 4 only. Additionally, incidence of graft take was reassessed and found to be decreased significan tly in groups with hyperglycemia (60.0%) vs. groups with normoglycemia (84. 6%), regardless of Gram-positive bacterial counts (p = 0.034).