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Understanding Burns and Diabetes: A 12-Year analysis into Outcomes and Challenges in Lower Extremity Reconstruction
Jos� Antonio Arellano, MD; Hilary Y. Liu, BS; Christopher J. Fedor, MS; Mare G. Kaulakis, BS; Alexis Henderson, MPH; Garth Elias,MD; Alain C. Corcos, MD, FACS; Jenny A. Ziembicki, MD; Francesco M. Egro, MD
University of Pittsburgh
2025-01-09
Presenter: Jose Antonio Arellano
Affidavit:
I certify that all data is original, not published.
Director Name: Vu T. Nguyen
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction
Burn injuries affect eight million people annually, while diabetes, which impacts 422 million globally, impairs wound healing and circulation. The rising prevalence of diabetes complicates burn management. This study analyzes outcomes and complications in diabetic patients undergoing lower extremity burn reconstruction, exploring the effects of diabetes on recovery.
Methods
A retrospective analysis was conducted on diabetic patients with lower extremity burns treated at a single ABA-verified burn center from 2012 to 2023. Data collected included demographics, burn characteristics, treatment methods, and outcomes. Logistic regression examined associations between burn-related factors and the probability of requiring surgical intervention.
Results
A total of 571 patients were included in the analysis, 65.3% of whom were male. Among them, 100 patients (18.0%) had diabetes, while 454 (82.0%) did not. The overall surgery rate was 52.5%, with no significant difference between diabetic and non-diabetic patients (p=0.691). Diabetic patients had a higher risk of reoperation (54.0% vs. 38.6%, p=0.004), osteomyelitis (5.8% vs. 0.48%, p<0.001), and cellulitis (46.2% vs. 27.5%, p<0.001). In multivariate analysis, adjusting for age and total body surface area (TBSA), diabetes was associated with twice the odds of re-intervention (OR=2.00, 95% CI [1.25, 3.20], p=0.004) and six times the odds of developing osteomyelitis (OR=6.04, 95% CI [1.10, 33.22], p=0.038). However, after adjustment, diabetes was no longer a significant predictor of cellulitis (OR=1.55, 95% CI [0.94, 2.55], p=0.084).
Conclusion
Diabetic patients have higher risks of reoperation and osteomyelitis, emphasizing the need for targeted surgical strategies and careful postoperative management.
