J. Buckley1, R. S. Elliott1, A. Seifi1 1University Of Texas Health Science Center At San Antonio,San Antonio, TX, USA
Introduction: Often utilized in the setting of serious trauma or burns, skin grafting procedures (SGP) are applied by physicians in order to transplant skin to a different area of the body where skin is absent. Using a robust database, we sought to determine the incidence of SGP for patients in the United States and the impact of an institution’s teaching status on these trends.
Methods: Utilizing the Nationwide Inpatient Sample database, we identified 1,567,966 discharges involving procedures requiring skin grafts (SGP, CCS Procedure Code 172) from 1997 to 2013 in United States. Year-wise distribution of number and rate of patients who underwent SPG at teaching and non-teaching hospitals was described. Z-test statistic was used to compare the two groups.
Results: During seventeen years of the study period, approximately 60.06% of patients who received procedures involving skin grafts (SGP) were males and 34.19% of patients were between 45 and 64 years old. The total annual number of patients who underwent SGP at all institutions increased insignificantly overall and ranged from 83,903 to 101,285 (Fig. 1, P=0.3185). The rate of patients who underwent skin grafts at all institutions varied insignificantly as well and ranged from 28.5 to 34.7 per 100,000 patients (P=0.2329). Throughout the duration of the study period, the mean number of SGP performed in teaching and non-teaching institutions was 64,505 and 26,832 respectively; with an average of 92,233 SGP occurring in all institutions annually. Annually, the number of patients who underwent SGP at teaching institutions ranged from 53,278 to 76,265, whereas the number of patients at non-teaching institutions ranged from 21,110 to 40,604. Notably, from 1997 to 2004 and from 2006 to 2013, the number of patients who received SGP was consistently and significantly higher for patients treated at teaching hospitals as opposed to those treated at non-teaching hospitals (Fig. 1, P<0.0001). However, from in 2005, there was no significant difference between the numbers of SGP performed by these two types of institutions.
Conclusion: The usage of procedures involving skin grafts (SGP) has been consistent in the United States during the past two decades. Teaching status of institutions has an impact on the utilization of SGP in patients. Future research should attempt to explore whether teaching status affects clinical outcomes for patients after SGP and make a recommendation to our patients regarding where to seek optimal care.
