Research Summary

Ibuprofen Not Linked to Elevated Bleeding Risk in Skin Grafting Following Burn Injury

Anthony Calabro, MA

Key Highlights

  • Ibuprofen use was not associated with increased perioperative bleeding or transfusion requirements in patients undergoing skin grafting for burns.
  • No cases of graft failure were observed in the ibuprofen cohort compared with a 6.9% rate in the non-ibuprofen group.
  • Rates of postoperative infection, seroma, and other complications were similar across groups.

In a retrospective study evaluating ibuprofen use in the context of burn surgery, researchers found no significant increase in bleeding risk or skin graft failure among patients receiving scheduled ibuprofen therapy during hospitalization.

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are increasingly used to reduce opioid reliance for postoperative pain management. However, NSAIDS can potentially increase bleeding risk in surgical settings where blood loss is already substantial, such as burn reconstruction. Limited data exist on the safety of ibuprofen specifically in skin grafting procedures following burn injury, prompting this investigation.

Researchers conducted a chart review of patients admitted with acute burn injury between January 1 and July 31, 2024, who underwent skin grafting. Of 53 eligible patients, 24 (45.2%) received scheduled ibuprofen. Primary outcomes included perioperative transfusion requirements, skin graft failure, bleeding events, and other complications such as seroma or infection.

The groups were well-matched in terms of burn severity, with total body surface area affected averaging 12.3% in the non-ibuprofen group and 14.3% in the ibuprofen group (P = .62). Perioperative transfusion requirements were not significantly different, with the non-ibuprofen group receiving an average of 4.6±3.1 units of packed red blood cells compared to 3.2±2.8 units in the ibuprofen group (P = .207). Skin graft failure occurred in 6.9% (n = 2) of patients not receiving ibuprofen and in none (n = 0) of the patients who did (P = .112). No significant differences were found in postoperative seroma (P = .259) or infection rates (P = .568), and no patients experienced hypersensitivity reactions or gastrointestinal bleeding.

The small sample size and retrospective design limit the generalizability of these findings. Additionally, the study period was short, and potential confounders related to comorbidities or concurrent medications were not fully controlled.

“There is likely no increased risk of bleeding or skin graft failure in patients taking ibuprofen, suggesting that these medications may be safe in this context,” the authors concluded.

Reference
Manasyan A, Gasho JO, Kim MI, Stanton EW, Johnson MB, Gillenwater TJ. Ibuprofen is not associated with an elevated bleeding risk or transfusion requirement in skin grafting for patients with burn injuries. J Burn Care Res. Published online February 26, 2025. doi:10.1093/jbcr/iraf015