{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:14:13Z","timestamp":1783509253093,"version":"3.55.0"},"reference-count":34,"publisher":"MDPI AG","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is an increased prevalence of foot ulceration in patients with diabetes, leading to hospitalization. Early wound closure is necessary to prevent further infections and, ultimately, lower-limb amputations. There is no current evidence stating that an elevated preoperative hemoglobin A1c (HbA1c) level is a contraindication to skin grafting. The purpose of this review was to determine whether elevated HbA1c levels are a contraindication to the application of skin grafts in diabetic patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review was performed of 53 consecutive patients who underwent split-thickness skin graft application to the lower extremity between January 1, 2012, and December 31, 2015. A uniform surgical technique was used across all of the patients. A comparison of HbA1c levels between failed and healed skin grafts was reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 43 surgical sites (41 patients) that met the inclusion criteria, 27 healed with greater than 90% graft take and 16 had a skin graft that failed. There was no statistically significant difference in HbA1c levels in the group that healed a skin graft compared with the group in which skin graft failed to adhere.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Preliminary data suggest that an elevated HbA1c level is not a contraindication to application of a skin graft. The benefits of early wound closure outweigh the risks of skin graft application in patients with diabetes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7547\/15-200","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T13:19:23Z","timestamp":1509110363000},"page":"365-368","source":"Crossref","is-referenced-by-count":16,"title":["Split-Thickness Skin Grafts to the Foot and Ankle of Diabetic Patients"],"prefix":"10.3390","volume":"107","author":[{"given":"Kyle","family":"Sanniec","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tea","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"van Asten","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier La","family":"Fontaine","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence A.","family":"Lavery","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"ref261","first-page":"1","article-title":"Skin grafts and skin substitutes and principles of flaps","volume":"10","author":"Thornton","year":"2004","journal-title":"Selected Readings in Plastic 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