August 11, 2025

Correlation between Preoperative Nutritional Prognostic Index and Split-Thickness Skin Graft Take in Severe Burn Patients

Key Points

Patients with a higher preoperative nutritional index had a significantly better split-thickness skin graft take, indicating better recovery.
A correlation coefficient of 0.628 (p<0.01) shows a strong link between preoperative PNI and successful graft take.
This case-control study analyzed 60 severe burn patients, comparing those with graft take above and below 85%.
Finding a significant relationship, the study highlights the potential of preoperative nutritional index as a useful prognostic tool.

Abstract

Background: Morbidity and mortality due to severe burns remain high. Severe burns require split-thickness skin grafts (STSG), and research on the factors influencing take of STSG success is always developing. The relationship between the preoperative Prognostic Nutritional Index (PNI) and take of STSG success, as measured by graft take percentage, has not been studied in Indonesia, despite PNI being an easily accessible and cost-effective tool. Methods: This case-control study involved 60 patients with severe burns at Burn Unit in I.G.N.G. Prof. Ngoerah General Hospital, Bali, Indonesia, from 2018 to 2024. Cases were patients with STSG take below 85%, and controls were patients with STSG take above 85%. Preoperative PNI and 14-day STSG-take rates were analyzed and correlated. Results: Statistical analysis revealed a significant correlation between preoperative PNI and STSG take in severe burn patients, with a correlation coefficient of 0.628 (p<0.01). The optimal PNI cutoff value was 23.5058. Preoperative PNI was significantly associated with the STSG take success (OR = 3.696; p < 0.001). Conclusion: Preoperative PNI predicts STSG take success in severe burn patients at Burn Unit in I.G.N.G. Prof. Ngoerah General Hospital. Keywords: Burn injury, skin graft, prognosis

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