{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:06:16Z","timestamp":1792785976338,"version":"4.5.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Lehigh Valley Health Network","id":[{"id":"https:\/\/ror.org\/00sf92s91","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Split-thickness skin grafts (STSGs) are essential for managing burns and non-healing wounds, but donor site complications such as dyspigmentation and hypertrophic features can impair long-term donor site appearance. Evidence on risk factors for donor site morbidity in large, diverse populations is limited. This retrospective study reviewed medical records of 1021 patients who underwent STSG procedures at a regional burn center from 2015 to 2024, including 559 patients with at least one postoperative follow-up visit documenting donor site appearance. Patient demographics, surgical characteristics, and donor site appearances were analyzed to identify risk factors. Fitzpatrick skin types IV, V, and VI accounted for 46.6% of patients presenting with hypertrophic features (P\u2009&amp;lt;\u2009.001), despite comprising 14.7% of the patient population. Older age (OR\u2009=\u20091.017 per year, P\u2009&amp;lt;\u2009.001) and a Body Mass Index \u226525 (OR\u2009=\u20092.00, P\u2009&amp;lt;\u2009.001) were associated with higher odds of dyspigmented donor sites. Diabetes and hypertension together elevated dyspigmentation risk (OR\u2009=\u20092.71, P\u2009&amp;lt;\u2009.001), with hypertension alone nearly doubling the risk (OR\u2009=\u20091.92, P\u2009&amp;lt;\u2009.001). Calcium alginate and silver dressings were associated with lower odds of dyspigmentation (OR\u2009=\u20090.368, P\u2009&amp;lt;\u2009.001), whereas film-only dressings more than doubled the risk (OR\u2009=\u20092.31, P\u2009&amp;lt;\u2009.001). Graft thickness and healing time were not statistically significant. These findings highlight the need for individualized care strategies that account for patient-specific risk factors to minimize donor site morbidity and improve long-term donor site outcomes after STSGs.<\/jats:p>","DOI":"10.1093\/jbcr\/irag158","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:48:06Z","timestamp":1788457686000},"source":"Crossref","is-referenced-by-count":0,"title":["Donor Site Scarring and Dyspigmentation Following Split-Thickness Skin Graft Procedure: A Large-Sample, Single-Site Retrospective Study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5919-5817","authenticated-orcid":false,"given":"Sakura","family":"Helm","sequence":"first","affiliation":[{"name":"Burn Recovery Center, Lehigh Valley Health Network , Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1163-5672","authenticated-orcid":false,"given":"Sigrid A","family":"Blome-Eberwein","sequence":"additional","affiliation":[{"name":"Burn Recovery Center, Lehigh Valley Health Network , Allentown, PA 18103 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"2026092808254166300_ref1","doi-asserted-by":"publisher","first-page":"e1928","DOI":"10.1097\/GOX.0000000000001928","article-title":"Meta-analysis and systematic review of skin graft donor-site dressings with future guidelines","volume":"6","author":"Serebrakian","year":"2018","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2026092808254166300_ref2","doi-asserted-by":"publisher","first-page":"1525","DOI":"10.1016\/j.burns.2021.02.014","article-title":"Split-thickness skin graft donor-site morbidity: a systematic literature review","volume":"47","author":"Asuku","year":"2021","journal-title":"Burns."},{"key":"2026092808254166300_ref3","volume-title":"StatPearls [Internet]","author":"Braza","year":"2025"},{"key":"2026092808254166300_ref4","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1111\/iwj.12860","article-title":"Health-related quality of life and patient burden in patients with split-thick skin graft donor site wounds","volume":"15","author":"Humrich","year":"2018","journal-title":"Int Wound J"},{"key":"2026092808254166300_ref5","volume-title":"Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]","author":"McDermott","year":"2006"},{"key":"2026092808254166300_ref6","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1016\/j.burns.2019.02.003","article-title":"Prevalence and risk factors for hypertrophic scarring of split thickness autograft donor sites in a pediatric burn population","volume":"45","author":"Rotatori","year":"2019","journal-title":"Burns."},{"key":"2026092808254166300_ref7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/01.ASW.0000720256.45983.28","article-title":"Scarring at donor sites after split-thickness skin graft: a prospective, longitudinal, randomized trial","volume":"33","author":"Karlsson","year":"2020","journal-title":"Adv Skin Wound Care"},{"key":"2026092808254166300_ref8","doi-asserted-by":"publisher","first-page":"51","DOI":"10.5999\/aps.2017.00563","article-title":"Risk factors for delayed healing at the free anterolateral thigh flap donor site","volume":"45","author":"Abe","year":"2018","journal-title":"Arch Plast Surg"},{"key":"2026092808254166300_ref9","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1111\/iwj.12967","article-title":"An evidence-based review of split-thickness skin graft donor site dressings","volume":"15","author":"Brown","year":"2018","journal-title":"Int Wound J"},{"key":"2026092808254166300_ref10","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.burns.2023.10.016","article-title":"First do no harm: a patient-reported survey of split skin graft donor site morbidities following thin and super-thin graft harvest","volume":"50","author":"Bache","year":"2024","journal-title":"Burns."},{"key":"2026092808254166300_ref11","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1016\/j.burns.2020.12.005","article-title":"Patient-reported scar quality of donor-sites following split-skin grafting in burn patients: long-term results of a prospective cohort study","volume":"47","author":"Legemate","year":"2021","journal-title":"Burns."},{"key":"2026092808254166300_ref12","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1016\/j.burns.2019.03.025","article-title":"Patterns and predictors of burn scar outcome in the first 12 months after burn: the patient\u2019s perspective","volume":"45","author":"Rashaan","year":"2019","journal-title":"Burns."},{"key":"2026092808254166300_ref13","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1097\/DSS.0000000000001345","article-title":"Healing time correlates with the quality of scarring: results from a prospective randomized control donor site trial","volume":"44","author":"Werdin","year":"2018","journal-title":"Dermatologic Surg"},{"key":"2026092808254166300_ref14","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1016\/j.burns.2021.04.005","article-title":"A systematic review and meta-analysis of randomized trials evaluating the efficacy of autologous skin cell suspensions for re-epithelialization of acute partial thickness burn injuries and split-thickness skin graft donor sites","volume":"47","author":"Bairagi","year":"2021","journal-title":"Burns."},{"key":"2026092808254166300_ref15","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1001\/archfaci.10.2.93","article-title":"Epidemiology and risk factors for pathologic scarring after burn wounds","volume":"10","author":"Gangemi","year":"2008","journal-title":"Arch Facial Plast Surg"},{"key":"2026092808254166300_ref16","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"2026092808254166300_ref17","doi-asserted-by":"publisher","first-page":"5","DOI":"10.29245\/2767-5092\/2022\/3.1157","article-title":"Effects of obesity on infections with emphasis on skin infections and wound healing","volume":"4","author":"Frasca","year":"2022","journal-title":"J Dermatol Skin Sci"}],"container-title":["Journal of Burn Care &amp; 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