Altameemi, A., Abolfotouh, S., Elsherbeny, K., Saad Eldin, M. (2025). The Clinical Usefulness of Neutrophil-Lymphocyte Ratio and Serum Procalcitonin as a Diagnostic and Prognostic Biochemical Markers in Burn Patients Complicated with Sepsis: A Comparative Study. The Egyptian Journal of Plastic and Reconstructive Surgery, 49(1), 1-8. doi: 10.21608/ejprs.2025.405178
Ali D. Altameemi; Sherine M Abolfotouh; Khaled M Elsherbeny; Mohamed O Saad Eldin. "The Clinical Usefulness of Neutrophil-Lymphocyte Ratio and Serum Procalcitonin as a Diagnostic and Prognostic Biochemical Markers in Burn Patients Complicated with Sepsis: A Comparative Study". The Egyptian Journal of Plastic and Reconstructive Surgery, 49, 1, 2025, 1-8. doi: 10.21608/ejprs.2025.405178
Altameemi, A., Abolfotouh, S., Elsherbeny, K., Saad Eldin, M. (2025). 'The Clinical Usefulness of Neutrophil-Lymphocyte Ratio and Serum Procalcitonin as a Diagnostic and Prognostic Biochemical Markers in Burn Patients Complicated with Sepsis: A Comparative Study', The Egyptian Journal of Plastic and Reconstructive Surgery, 49(1), pp. 1-8. doi: 10.21608/ejprs.2025.405178
Altameemi, A., Abolfotouh, S., Elsherbeny, K., Saad Eldin, M. The Clinical Usefulness of Neutrophil-Lymphocyte Ratio and Serum Procalcitonin as a Diagnostic and Prognostic Biochemical Markers in Burn Patients Complicated with Sepsis: A Comparative Study. The Egyptian Journal of Plastic and Reconstructive Surgery, 2025; 49(1): 1-8. doi: 10.21608/ejprs.2025.405178
The Clinical Usefulness of Neutrophil-Lymphocyte Ratio and Serum Procalcitonin as a Diagnostic and Prognostic Biochemical Markers in Burn Patients Complicated with Sepsis: A Comparative Study
The Department of Plastic, Burn and Maxillofacial Surgery, Ain Shams University
Abstract
Background: Burn injuries have become a major global health problem, with more than 120,000 burn-related deaths each year. Aim and Objectives: To compare Neutrophil-lymphocyte Ratio (NLR) and S. Procalcitonin (PCT) level as a diagnostic and prognostic parameter in burn patients complicated with sepsis. Patients and Methods: This was a prospective cohort study conducted on 40 patients at burn unit of the Plastic, Burn and Maxillofacial Surgery Department in Ain Shams University Hospitals from April to September 2023. According to the American Burn Association Criteria for the presence of infection, the patients were allocated into two groups: Sepsis and non-sepsis. Also, according to the fate of the patients, they were classified into two groups: Non survivors and survivors (discharged). We measured NLR and PCT as markers of infection on admission, day 3, day 10 and day 20 for all patients and compared their values in the finding groups. Results: There was no statistically significant difference between sepsis and non-sepsis patients as well as between survivors and non-survivors as regard NLR. There was Statistically significant increased PCT level on day 3 from admission and statistically highly significant increase on day 10 with sepsis patients when compared with non-sepsis patients (p=0.003 and increased PCT level on day 3 and statistically highly significant increase on day 10 with non-survivor when compared with survivor patients (p=0.043 and Conclusion: Our study demonstrated that PCT level in major burn patients is a promising diagnostic biomarker in detecting sepsis that could facilitate ideal management and initiate proper antimicrobial therapy and good prognostic value as an early predictor of mortality. In contrast, higher NLR cannot be considered as a reliable independent predictor of sepsis.
Lee K.T., Wiraatmadja E.S. and Mun G.H.: Free latissimus dorsi muscle-chimeric thoracodorsal artery perforator flaps for reconstruction of complicated defects: Does muscle still have a place in the domain of perforator flaps? Ann. Plast. Surg., May 74 (5): 565-72, 2015. 2- Homsen J.B. and Gunnarsson G.L.: The evolving breast reconstruction: From latissimus dorsi musculocutaneous flap to a propeller thoracodorsal fasciocutaneous flap. Gland Surg., Aug. 3 (3): 151-4, 2014. 3- Feng A.L., Nasser H.B., Rosko A.J., Casper K.A., Malloy K.M., Stucken C.L., Prince M.E., Chinn S.B. and Spector M.E.: Revisiting pedicled latissimus dorsi flaps in head and neck reconstruction: Contrasting shoulder morbidities across myofascial flaps. Plast. Aesthet. Res., 2021; 8:10.20517/2347-9264.2021.03. 4- Chen S.L., Chen T.M. and Wang H.J.: Free thoracodorsal artery perforator flap in extremity reconstruction: 12 cases. Br. J. Plast. Surg., 57: 525-30, 2004. 5- Park B.Y.: Flap thinning: Defatting after conventional elevation. Arch. Plast. Surg., Jul. 45 (4): 314-318, 2018. 6- Sever C., Uygur F., Kulahci Y., Karagoz H. and Sahin C.: Thoracodorsal artery perforator fasciocutaneous flap: A versatile alternative for coverage of various soft tissue defects. Indian J. Plast. Surg., Sep. 45 (3): 478-84, 2012. 7- Ezequiel Escudero, Ludmila Grassano, Claudio Angrigiani, Alberto Rancati, Roger K. and Khouri Jr., B.S.: Thoracodorsal Artery Perforator Flap for Bilateral Breast Reconstruction: Simultaneous Vs Staged. Michigan Journal of Medicine, April Volume 2, Issue 1, 2017. 8- Mustafa A.Y.A.A. and Alasmari W.: Anatomical Study of the Latissimus Dorsi Muscle Flap. Int. J. Morphol., Vol. 40, n.3, pp.562-565, 2022. 9- Hassan K., Awadein A. and Abdelhamid M.: Neurovascular Anatomy of the Split Latissimus Dorsi Muscle Flap for the Purpose of Smile Restoration. The Egyptian Journal of Plastic and Reconstructive Surgery, 43 (3): 565-573, 2019. 10- Li S-Q., Zheng Z-F., Li H., Zhang J-F., Zheng Y. and Lin L-S.: Clinical Study on the Thoracodorsal Artery Perforator Flap in Breast-Conserving Reconstruction of T2 Breast Cancer. Surgical Innovation, 31 (1): 16-25, 2024. 11- Tansatit T., Chokrungvaranont P., Wanidchaphloi S. and Sanguansit P.: The anatomy of the thoracodorsal artery in perforator flap for resurfacing shallow defect. J. Med. Assoc. Thai., May 90 (5): 947-55, 2007. 12- Hifny M.A., Tohamy A.M.A., Rabie O. and Ali A.A.A.: Propeller perforator flaps for coverage of soft tissue defects in the middle and distal lower extremities, Annales de Chirurgic Plastique Esthétique, Volume 65, Issue 1: 54- 60, 2020. 13- Hantash S., Ayad W., Hendy A.A. and Sadaka M.S.: Clinical applications of the thoracodorsal artery perforator flap in extremity soft tissue reconstruction. The Egyptian Journal of Plastic and Reconstructive Surgery, 44 (2): 353-359, 2020. 14- Dias, Leonardo Pires Novais, Marzia Salgarello and Moustapha Hamdi: “History of Pedicled Perforator Flaps for Breast Reconstruction.” Pedicled Flaps in Partial Breast Reconstruction. Springer International Publishing, 1-18, 2023. 15- Angrigiani C., Grilli D. and Siebert J.: Latissimus dorsi musculocutaneous flap without muscle. Plast. Reconstr. Surg., 96: 1608–14, 1995.