Comparison of Excision and Graft of Early-Onset and Late-Onset Burns: A Systematic Review
DOI:
https://doi.org/10.59188/eduvest.v5i9.51194Keywords:
Epithelialization, Burns, Graft, Wound healingAbstract
Autologous skin grafts are generally considered the gold standard for covering large skin defects in burn patients. Full-thickness skin grafts produce the best aesthetic and functional results in burn reconstruction. Many techniques and adjustments have been developed over time, and even the optimal timing for intervention remains a debatable topic. This article will discuss the comparison of excision and graft actions for early-onset and late-onset burns. This research used the PRISMA 2020 standard, ensuring that all requirements were met. The studies included in this article were published between 2015 and 2025 and were sourced from the Google Scholar database and other web resources. The search yielded nine studies relevant to the research objectives from the last ten years. Relevant articles generally suggest that early intervention can provide longer-lasting benefits and lower treatment costs, albeit inconsistently in terms of complications during treatment—for example, the need for transfusions and shock events. Early skin graft and excision management can reduce both treatment duration and cost. Research outcomes based on patient satisfaction showed that interventions performed at early onset resulted in higher satisfaction.
References
Ayaz, M., Karami, M. Y., Deilami, I., & Moradzadeh, Z. (2019). Effects of early versus delayed excision and grafting on restoring the functionality of deep burn-injured hands: A double-blind, randomized parallel clinical trial. Journal of Burn Care & Research, 40(4), 451–456. https://doi.org/10.1093/jbcr/irz033
Badr, M. L. A., Keshk, T. F., Alkhateeb, Y. M., & El Refaai, A. M. E. (2019). Early excision and grafting versus delayed grafting in deep burns of the hand. International Surgery Journal, 6(10), 3530–3535.
Botman, M., Beijneveld, J. A., Negenborn, V. L., Hendriks, T. C. C., Schoonmade, L. J., Mackie, D. P., Ritt, M. J. P. F., Bosma, E., Dokter, J., van Baar, M. E., Nieuwenhuis, M. K., van der Vlies, C. H., & Middelkoop, E. (2019). Surgical burn care in sub-Saharan Africa: A systematic review. Burns Open, 3(4), 129–134.
Branski, L. K., Herndon, D. N., & Barrow, R. E. (2018). A brief history of acute burn care management. In Total burn care (pp. 1–7). Elsevier.
Dargan, D., Kazzazi, D., Limnatitou, D., Cochrane, E., Stubbington, Y., Shokrollahi, K., Bishop, J., & Moiemen, N. (2021). Acute management of thermal hand burns in adults: A 10-year review of the literature. Annals of Plastic Surgery, 86(5), 517–531.
Gallaher, J. R., Mjuweni, S., Shah, M., Cairns, B. A., & Charles, A. G. (2015). Timing of early excision and grafting following burn in sub-Saharan Africa. Burns, 41(6), 1353–1359. https://www.sciencedirect.com/science/article/pii/S0305417915000492
Gawaziuk, J. P., Peters, B., & Logsetty, S. (2018). Early ambulation after-grafting of lower extremity burns. Burns, 44(1), 183–187.
Glaser, J., Ziegler, B., Hirche, C., Tapking, C., Haug, V., Bliesener, B., Herndon, D. N., Vogt, P. M., & Kneser, U. (2021). The status quo of early burn wound excision: Insights from the German burn registry. Burns, 47(6), 1259–1264. https://www.sciencedirect.com/science/article/pii/S0305417921001698
Gojowy, D., Kauke, M., Ohmann, T., Homann, H.-H., & Mannil, L. (2019). Early and late-recorded predictors of health-related quality of life of burn patients on long-term follow-up. Burns, 45(6), 1300–1310.
Goswami, P., Sahu, S., Singodia, P., Kumar, M., Tudu, T., Kumar, A., Kispotta, A. K., & Tiwary, S. K. (2019). Early excision and grafting in burns: An experience in a tertiary care industrial hospital of Eastern India. Indian Journal of Plastic Surgery, 52(03), 337–342.
Greenwood, J. E. (2020). A paradigm shift in practice—the benefits of early active wound temporisation rather than early skin grafting after burn eschar excision. Anaesthesia and Intensive Care, 48(2), 93–100. https://doi.org/10.1177/0310057X19895788
Hahler, B. (2006). Surgical wound dehiscence. Nursing, 15(5), 296.
Hayashi, K., Sasabuchi, Y., Matsui, H., Nakajima, M., Otawara, M., Ohbe, H., Goto, T., Fushimi, K., & Yasunaga, H. (2023). Does early excision or skin grafting of severe burns improve prognosis? A retrospective cohort research. Burns, 49(3), 554–561. https://www.sciencedirect.com/science/article/pii/S0305417923000141
Heller, L., Levin, S., & Butler, C. (2006). Management of abdominal wound dehiscence using vacuum assisted closure in patients with compromised healing. American Journal of Surgery, 192(6), 165.
Hundeshagen, G., Warszawski, J., Tapking, C., Ziegler, B., Hirche, C., Kneser, U., & Herndon, D. N. (2020). Concepts in early reconstruction of the burned hand. Annals of Plastic Surgery, 84(3), 276–282.
Jackson, S. R., & Roman, S. (2019). Matriderm and split skin grafting for full-thickness pediatric facial burns. Journal of Burn Care & Research, 40(2), 251–254.
Jeschke, M. G., Shahrokhi, S., Finnerty, C. C., Branski, L. K., Dibildox, M., & Committee ABAO& D of BC. (2018). Wound coverage technologies in burn care: Established techniques. Journal of Burn Care & Research, 39(3), 313–318.
Jeschke, M. G., van Baar, M. E., Choudhry, M. A., Chung, K. K., Gibran, N. S., & Logsetty, S. (2020). Burn injury. Nature Reviews Disease Primers, 6(1), 11.
Kohlhauser, M., Luze, H., Nischwitz, S. P., & Kamolz, L. P. (2021). Historical evolution of skin grafting—A journey through time. Medicina, 57.
Mason, S. A., Nathens, A. B., Byrne, J. P., Gonzalez, A., Fowler, R., Karanicolas, P. J., Widder, S., Rizoli, S., & Govindarajan, A. (2017). Trends in the epidemiology of major burn injury among hospitalized patients: A population-based analysis. Journal of Trauma and Acute Care Surgery, 83(5), 867–874.
Pruitt, B. A., Wolf, S. E., & Mason, A. D. (2012). Epidemiological, demographic, and outcome characteristics of burn injury. Total Burn Care, 4, 15–45.
Puri, V., Khare, N. A., Chandramouli, M. V., Shende, N., & Bharadwaj, S. (2016). Comparative analysis of early excision and grafting vs delayed grafting in burn patients in a developing country. Journal of Burn Care & Research, 37(5), 278–282. https://doi.org/10.1097/BCR.0b013e31827e4ed6
Rennekampff, H.-O., & Tenenhaus, M. (2022). Damage control surgery after burn injury: A narrative review. European Burn Journal, 3(2), 278–289.
Singer, A. J., Toussaint, J., Chung, W. T., McClain, S. A., Raut, V., & Rosenberg, L. (2016). Early versus delayed excision and grafting of full-thickness burns in a porcine model: A randomized research. Plastic and Reconstructive Surgery, 137(6). https://journals.lww.com/plasreconsurg/fulltext/2016/06000/early_versus_delayed_excision_and_grafting_of.25.aspx
Sorg, H., Tilkorn, D. J., Hager, S., Hauser, J., & Mirastschijski, U. (2017). Skin wound healing: An update on the current knowledge and concepts. European Surgical Research, 58(1–2), 81–94.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ni Putu Tiza Murtia Margha Margha, Gde Dedy Andika
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
