Incidence and predictors of lower limb split-skin graft failure and primary closure dehiscence in day-case surgical patients

Stankiewicz, Monica, Coyer, Fiona, Webster, Joan, & Osborne, Sonya (2015) Incidence and predictors of lower limb split-skin graft failure and primary closure dehiscence in day-case surgical patients. Dermatologic Surgery, 41(7), pp. 775-783.

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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).

CONCLUSION 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.

Impact and interest:

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ID Code: 86658
Item Type: Journal Article
Refereed: Yes
Keywords: aged, surgical patient, surgical site failure, surgical infection, split thickness skin graft, major clinical study, graft failure, hematoma, logistic regression analysis, observational study, predictive value, skin graft, priority journal
DOI: 10.1097/DSS.0000000000000391
ISSN: 1076-0512
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Nursing not elsewhere classified (111099)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2015 American Society for Dermatologic Surgery, Inc.
Copyright Statement: This is a non-final version of an article published in final form in Dermatologic Surgery: July 2015 - Volume 41 - Issue 7 - p 775–783 doi: 10.1097/DSS.0000000000000391
Deposited On: 19 Aug 2015 06:19
Last Modified: 20 Nov 2016 14:50

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