Risk factors for wound dehiscence after surgery for epilepsy

Area of Science:

• Neurosurgery
• Surgical Complications
• Epilepsy Treatment

Background:

• Wound dehiscence is a complication following craniotomy, necessitating further procedures for closure.
• Craniotomy is a key surgical intervention for intractable epilepsy.
• Risk factors for post-craniotomy wound dehiscence remain largely undetermined.

Purpose of the Study:

• To identify independent risk factors for wound dehiscence after epilepsy surgery.
• To analyze the association between surgical techniques and wound dehiscence.
• To provide recommendations for preventing wound dehiscence in epilepsy surgery.

Main Methods:

• Retrospective review of clinical records and operative notes from 2015-2023.
• Inclusion of consecutive patients with intractable epilepsy undergoing craniotomy for resective or disconnective surgery.
• Multivariate logistic regression analysis to determine independent risk factors for wound dehiscence.

Main Results:

• Wound dehiscence occurred in 8.0% of 174 patients.
• Independent risk factors identified: skin incision with electrocautery scalpel (OR 9.38) and dural closure with nonabsorbable artificial dura (OR 6.29).
• Other factors associated with dehiscence included CR via IVEEG, T-shaped incisions, and longer operative duration.

Conclusions:

• Surgical devices and materials significantly contribute to wound dehiscence after epilepsy surgery.
• Recommendations include avoiding electrocautery scalpels for skin incisions.
• Avoidance of nonabsorbable artificial dura for dural closure is advised to prevent wound dehiscence.