Risk Factors for Surgical Wound Infection and Fascial Dehiscence After Open Gynecologic Oncologic Surgery: A...

Area of Science:

• Gynecologic Oncology
• Surgical Outcomes
• Infectious Disease

Background:

• Surgical site infections (SSI) and fascial dehiscence (FD) are common complications.
• Risk factors for SSI and FD are well-documented but often exclude gynecological cancer patients.
• This study focuses on identifying SSI and FD risk factors in this specific patient population.

Purpose of the Study:

• To assess key risk factors for SSI and FD in gynecological oncological patients undergoing median laparotomy.
• To investigate the interplay between surgical duration, bowel manipulation, and wound complications.
• To explore the influence of patient demographics, such as age and BMI, on SSI risk.

Main Methods:

• Retrospective cohort study of 204 gynecological cancer patients undergoing median laparotomy (2017-2020).
• Utilized machine learning (random forest) to identify predictor interactions.
• Developed and validated a multivariable logistic regression model.

Main Results:

• 24.5% of patients developed SSI, and 8.8% experienced additional FD.
• Surgical duration was independently associated with SSI and FD, but only when the bowel was opened.
• Lower patient age significantly modified the effect of BMI on SSI risk.

Conclusions:

• Surgical duration is a critical predictor of SSI and FD in gynecological cancer patients.
• The impact of operation time on wound complications is contingent on whether bowel surgery is performed.
• Obesity poses a greater SSI risk in younger gynecological cancer patients compared to older ones.