title: Incidence and Predictors of Lower Limb Split-Skin Graft Failure and Primary Closure Dehiscence in Day-Case Surgical Patients.
abstract: BACKGROUND
  After general surgery, the lower limb experiences some of the highest complication rates. However, little is known about contributing factors to surgical site failure in the lower limb dermatological surgery population.
  
  
  OBJECTIVE
  To determine the incidence of lower limb surgical site failure and to explore the predictors that contribute to surgical site failure.
  
  
  METHODS
  A prospective observational study design was used to collect data from 73 participants, from July 2010, to March 2012. Incidence was determined as a percentage of surgical site failure from the total population. Predictors were determined by the use of a binary logistic regression model.
  
  
  RESULTS
  The surgical site failure rate was 53.4%. Split-skin grafting had a higher failure rate than primary closures, 66% versus 26.1%. Predictors of lower limb surgical site failure were identified as increasing age (p = .04) and the presence of postoperative hematoma (p = .01), with all patients who developed surgical site infection experiencing surgical site failure (p = .01).
  
  
  CONCLUSIONS
  Findings from this study confirmed that the lower limb is at high risk of surgical site failure. Two predictors of surgical site failure from this cohort were determined. However, to understand this phenomenon and make recommendations to assist and reduce surgical site complications, further research in this field is required.
authors.affiliation: *Private Practice, Brisbane, Australia; †School of Nursing, Queensland University of Technology, Brisbane, Australia; ‡Research and Development Unit, The Royal Brisbane and Women's Hospital, Brisbane, Australia.
authors.forename: Monica
authors.initials: M
authors.lastname: Stankiewicz
authors.forename: Fiona
authors.initials: F
authors.lastname: Coyer
authors.forename: Joan
authors.initials: J
authors.lastname: Webster
authors.forename: Sonya
authors.initials: S
authors.lastname: Osborne
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation; D013529:Surgical Wound Dehiscence / Q000453:epidemiology*