Delayed Grafting as a Valid Technique in Burn Management: Experience from a Burn Unit in Oman

Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.