Optimization of Early Surgical Closure of Burn Wounds Using an Improved Free Skin Grafting Technique

Objective: To evaluate the immediate and long-term outcomes of an improved free skin grafting technique using an antibiotic-impregnated hemostatic sponge placed directly on the wound bed. Material and methods: The results of comprehensive examination and treatment were analyzed in 232 patients with deep skin burns of grade IIIb–IV (grade III according to ICD-10) who were hospitalized between 2016 and 2025. The main study group consisted of 128 patients who underwent the proposed free skin grafting technique (patented invention), involving placement of a 0.5–1.0 cm thick hemostatic collagen sponge (based on type I collagen derived from bovine dermis; pharmacopoeial name: “hemostatic collagen sponge”) impregnated with a broad-spectrum antibiotic solution directly onto the prepared wound bed, followed by placement of a split-thickness autologous skin graft over the sponge. The comparison group consisted of 104 patients who underwent standard autologous skin grafting. Results: The main study group demonstrated a statistically significant increase in autologous skin graft take to 89.1% compared with 71.2% in the comparison group ( p <0.001), a decrease in the incidence of subgraft hematomas and seromas (4.7% vs 15.4%), and a shorter duration of hospital stay. Overall mortality in the main study group decreased to 8.6% compared with 17.3% in the comparison group. Long-term outcomes confirmed the formation of elastic functionally intact skin coverage without pronounced scar formation. Conclusion: The use of the improved free skin grafting technique provides reliable local hemostasis, targeted antibacterial activity, and a statistically significant improvement in functional and cosmetic treatment outcomes.