Influencing factors and their predictive value of skin graft survival after Meek grafting in severe burn patients

Objective: To investigate the influencing factors and their predictive value of skin graft survival after Meek grafting in severe burn patients. Methods: Totally 115 severe burn patients (95 males, 20 females, aged 1-74 years) who were conforming to the inclusion criteria received Meek grafting in the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from January 2013 to December 2019, among whom a case-control study was conducted. The patients were divided into good skin survival group with skin graft survival rate≥70% (68 cases) and poor skin graft survival group with skin graft survival rate optimal threshold group and independent risk factor≤optimal threshold group, the chi square test was used to compare the incidence of poor skin graft survival after Meek grafting, and the relative risk of poor skin graft survival after Meek grafting was calculated. Results: Before 1∶1 PSM, there were no statistically significant differences in gender, age, body mass index, complication of inhalational injury, time from injury to operation, preoperative cystatin C level, preoperative albumin level, preoperative neutrophil percentage, preoperative hemoglobin level of patients between the two groups (P>0.05); the full-thickness burn area and burn index of patients in poor skin graft survival group were significantly higher than those in good skin graft survival group (Z=-2.672, -2.882, P 0.05); the preoperative platelet count and the platelet count on the first, third, and fifth day after operation of patients in poor skin graft survival group were significantly lower than those in good skin graft survival group (Z=-3.428, -2.940, t=-2.427, -2.316, P 98×10(9)/L group (χ(2)=10.376, P 98×10(9)/L group, patients in preoperative platelet count≤98×10(9)/L had a relative risk of poor skin graft survival after Meek grafting of 2.211 (95% confidence interval=1.263-3.870). Conclusions: Preoperative platelet count is an independent risk factor affecting the skin graft survival after Meek grafting in severe burn patients, and has a good predictive value. Meek grafting should be performed with caution when the preoperative platelet count of patients is≤98×10(9)/L.