Effects of punctate skin grafting combined with or without irrigation on skin graft survival, redness and swelling score and pain in treatment of large-area residual burn wounds

OBJECTIVE: To investigate the effects of punctate skin grafting combined with or without irrigation on skin graft survival, redness and swelling score and pain in the treatment of large-area residual burn wounds. METHODS: A prospective study was conducted on 102 patients with large-area burns treated in Huangshi Central Hospital from May 2017 to May 2020. According to different treatment methods, they were divided into combination group (treated with punctate skin grafting combined with irrigation) and grafting group (mainly treated with punctate skin grafting). The positive rate of bacterial culture of wound secretions, pain score and redness and swelling score were analyzed and compared between the two groups. Additionally, linear logistic analysis of the influencing factors was carried out. RESULTS: The positive rate of bacterial culture of wound secretions decreased to 29.4% in the combination group and 49.0% in the grafting group (p< 0.05). The skin graft survival rate of the combination group was (82.17 ± 7.44) %, which was higher than that of the grafting group (61.53 ± 7.46) %, the wound healing time was (14.56 ± 3.51) d, which was shorter than that of the grafting group (21.36 ± 4.69) d, and the pain score (3.26 ± 0.36) and redness and swelling score (1.16 ± 0.68) were lower than those of the grafting group (4.79± 0.46) and (2.56 ± 0.85), respectively (all p< 0.05). The wound healing time was positively correlated with pain score (r = 0.767, p< 0.05) and redness and swelling score (r = 0.672, p< 0.05), while negatively correlated with skin graft survival rate (r= -0.289, P<0.01), meeting linear equation y = -8.451 + 4.542a + 0.087b + 1.012c (a, pain score; b, skin graft survival rate; c, redness and swelling score). CONCLUSIONS: Punctate skin grafting combined with irrigation in the treatment of large-area residual burn wounds presents great effects on skin graft survival, redness and swelling score and pain, and is worthy of clinical application and promotion.