Obstructive sleep apnea is an independent risk factor for split-thickness skin graft failure.

IF 1.1 4区医学 Q3 DERMATOLOGY

Wounds : a compendium of clinical research and practice Pub Date : 2025-07-01

Karen R Li, Rachel N Rohrich, Christian X Lava, Perry J Diaz, Sabrina F DeLeonibus, Winnie Li, Medhat S Hannallah, Christopher E Attinger

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引用次数: 0

Abstract

Background: Obstructive sleep apnea (OSA) is an underdiagnosed and undertreated disease that has been significantly associated with diabetes, cardiovascular disease, peripheral arterial disease, and poor wound healing.

Objective: To determine whether or not OSA is an independent risk factor for split-thickness skin graft (STSG) failure in patients with chronic lower extremity (LE) wounds, given OSA's disease burden to common comorbidities in the LE wound population.

Methods: A retrospective chart review of chronic LE wounds managed with STSG between December 2014 and December 2022 was conducted. Patients with a diagnosis of OSA ("OSA") were compared with patients without an OSA diagnosis ("Non-OSA").

Results: Overall, 14.9% of patients had OSA (n = 25) and 85.1% (n = 143) did not have OSA. Patients with OSA had a significantly higher median body mass index than the Non-OSA group (32.9 and 28.2, respectively; P = .013) and a higher rate of chronic obstructive pulmonary disease (16.0% and 4.2%, respectively; P = .043). Compared with patients without OSA, patients with OSA had more superficial wounds (P = .027) and received thinner skin grafts (P = .016). Compared with the Non-OSA group, wounds in the OSA group had significantly higher rates of graft failure (OSA 30.6% vs Non-OSA 15.9%; P = .034), infection (OSA 27.8% vs Non-OSA 10.6%; P = .005), and reoperation (OSA 52.8% vs Non-OSA 31.1%; P = .010). On multivariate logistic regression, OSA remained a significant risk factor for graft failure, increasing the odds of graft failure by 8.6 times (P = .040).

Conclusion: OSA is an independent predictor of graft failure in a highly comorbid population with chronic LE wounds. Preoperative identification of these high-risk patients should be undertaken by anesthesia, sleep medicine, and surgical teams to improve outcomes.

本刊更多论文

阻塞性睡眠呼吸暂停是裂皮移植失败的独立危险因素。

背景：阻塞性睡眠呼吸暂停（OSA）是一种未被充分诊断和治疗的疾病，与糖尿病、心血管疾病、外周动脉疾病和伤口愈合不良显著相关。目的：考虑到慢性下肢（LE）伤口患者的疾病负担和常见合并症，确定OSA是否是慢性下肢（LE）伤口患者分厚皮移植（STSG）失败的独立危险因素。方法：回顾性分析2014年12月至2022年12月间使用STSG治疗慢性LE伤口的病例。诊断为OSA的患者（“OSA”）与未诊断为OSA的患者（“非OSA”）进行比较。结果：总体而言，14.9%的患者有OSA (n = 25)， 85.1%的患者没有OSA （n = 143）。OSA患者的中位体重指数明显高于非OSA组(分别为32.9和28.2；P = 0.013)和更高的慢性阻塞性肺疾病发病率(分别为16.0%和4.2%；P = .043)。与未患OSA的患者相比，OSA患者有更多的浅表创面（P = 0.027），植皮更薄（P = 0.016）。与非OSA组相比，OSA组伤口移植失败率显著高于非OSA组(30.6% vs 15.9%；P = 0.034)，感染(OSA 27.8% vs Non-OSA 10.6%；P = 0.005)，再次手术(OSA 52.8% vs Non-OSA 31.1%；P = .010)。多因素logistic回归分析显示，OSA仍是移植物失败的重要危险因素，使移植物失败的几率增加8.6倍（P = 0.040）。结论：OSA是慢性LE伤口高合并症患者移植物衰竭的独立预测因子。术前应由麻醉、睡眠药物和外科团队对这些高危患者进行识别，以改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Wounds : a compendium of clinical research and practice 医学-皮肤病学

CiteScore

1.50

自引率

11.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Wounds is the most widely read, peer-reviewed journal focusing on wound care and wound research. The information disseminated to our readers includes valuable research and commentaries on tissue repair and regeneration, biology and biochemistry of wound healing, and clinical management of various wound etiologies. Our multidisciplinary readership consists of dermatologists, general surgeons, plastic surgeons, vascular surgeons, internal medicine/family practitioners, podiatrists, gerontologists, researchers in industry or academia (PhDs), orthopedic surgeons, infectious disease physicians, nurse practitioners, and physician assistants. These practitioners must be well equipped to deal with a myriad of chronic wound conditions affecting their patients including vascular disease, diabetes, obesity, dermatological disorders, and more. Whether dealing with a traumatic wound, a surgical or non-skin wound, a burn injury, or a diabetic foot ulcer, wound care professionals turn to Wounds for the latest in research and practice in this ever-growing field of medicine.