Effect of using allograft versus non-usage on the survival of major burn patients admitted to Imam Reza Hospital in Mashhad

Introduction: Skin allograft is the gold standard for temporarily covering the burn injury. Even in partial thickness burns, skin allograft in comparison to topical antimicrobial dressing, can reduce morbidity and hospital stay in burn patients. However, there is not any study about the effects of skin allograft on survival of burn patients in this country. The aim of this study was to evaluate the impact of allograft usage on hospitalization period and mortality in Imam Reza(p) hospital referral burn center in the East of the country. Subjects&Methods: This case-control study was performed on major burn patients who underwent skin allografts in Imam Reza(p) hospital in Mashhad between September 23, 2010 and September 22, 2014. The control group comprised patients hospitalized in the burn ward who were not undergoing allograft surgery. They were matched for age, sex and percentage of burn with case group. Study outcome was the hospitalization period and the patient's status at discharge (alive, deceased). Data were analyzed by SPSS version 11.5 using Kaplan–Meier and Log-rank test. Cox -regression was used to find predictors of death. Results: Overal, 56 patients in the case group and 112 patients in the control group were studied. The death rate in the two groups was not statistically different (P = 0.434), but hospitalization period in the case group (39 ± 13.9) was significantly longer than the control group (21.8 ± 14.5)(P<0.001). Mean survival time of cases (51 days, 95CI=45-56) was higher than the control group (48 days, 95CI=39-58)(P=0.017). Age (OR=1.03, CI95=1.005-1.070) and number of allograft usage (OR=0.038, CI95=0.142-0.945) were predictors of death. Conclusion: Although the use of allograft skin in extensive burns (over 50) reduced the mortality of burn patients, but it was ineffective in burns less than 50 percent. Considering the shortage of skin allograft in most burn centers in this country, it is advisable to reserve this life-saving product for extensively burnt patients.