Clinical Data on the Use of Meshed Grafts in Severe Burn Patients in Albania.

Abstract

Burns are among the most severe and painful injuries, affecting individuals of all ages, including children, adults and the elderly. The gold standard for burn wound coverage is autologous split-thickness skin grafts (STSGs) harvested from an uninjured donor site. These grafts can be expanded through meshing to ensure complete wound coverage. This study aims to present data on applying meshed grafts as a surgical treatment for severe burn patients hospitalized in the Intensive Care Unit (ICU) of the Burn Service at the University Hospital Center "Mother Teresa" in Tirana, Albania. Additionally, it describes our surgical methods for treating severe burns and assesses the limits of survival in critically ill patients within our service. Patients who underwent meshed graft surgery accounted for 20% of all surgical interventions performed on individuals with burns, burn sequelae and trauma. Key factors influencing the decision for meshed graft application included age, total body surface area burned (TBSA%), sepsis, and full-thickness burns. Sepsis and full-thickness burns were significant determinants in the surgical approach. Our surgical protocol involved selective procedures, including multiple escharotomies and delayed escharectomy, typically performed between the 2^nd and 3rd week post-injury. Skin grafting, either with full-thickness or meshed partial-thickness grafts, was subsequently applied to achieve complete wound closure. Multiple escharotomies facilitated wound management, while delayed escharectomy proved to be a safe and effective technique. Our findings suggest that survival is possible in patients with burns covering up to 60% TBSA, with 30-40% classified as full-thickness burns.