Predictors of split thickness skin graft failure at Kiruddu National Referral Hospital in Uganda

Abstract Introduction: Graft failure results in delayed wound healing, increased hospital stays, repeat surgery, further donor sites and increased scar formation. There is limited information specifically about predictors of split skin graft failure in the lower limbs. The purpose of this study was to determine the predictors of split thickness skin graft failure at Kiruddu National Referral Hospital (KNRH) in Uganda. Methods: This was a prospective longitudinal study in which patients who had split skin graft on the lower limbs were followed up till the 10th day to assess the graft failure rates. Graft failure was defined as any take less than 80% on the 10th post-operative day. The baseline characteristics, clinical characteristics and laboratory characteristics were documented and association with graft failure assessed using Poisson regression in SPSS version 26. Results: We enrolled 160 study participants, majority of whom were female 84(52.5%) with a mean age of 32.5 years (SD=19.4). In this study, 59/160 participants had graft failure. The predictors of skin graft failure were smoking, diabetes mellitus comorbidity, being underweight or obese and presence of hypoalbuminemia. The risk of skin graft failure was independently increased by 27.2% for smokers, 25.0% for the diabetics, 12.4% for those underweight, 5.4% for those obese and by 16.5% for those who had hypoalbuminemia (P<0.05 for all). Conclusion: More attention to reduce the risk of graft failure should be focused on smokers, diabetics, these with high or low body mass index and correcting serum albumin.