Analysis of risk factors for poor incision healing after the Nuss procedure for pectus excavatum
Xiaoyan Liu1, Fan Yang1, Zhenlei Jia1
1Department of Thoracic Surgery, Hebei Children's Hospital, Shijiazhuang, Hebei, China; Hebei Provincial Clinical Research Center for Child Health and Disease, Shijiazhuang, Hebei, China; Hebei Provincial Medical Key Discipline, Shijiazhuang, Hebei, China.
Insights
Children undergoing the Nuss procedure for pectus excavatum face risks of poor incision healing. Low BMI, asymmetric pectus excavatum, allergies, wire fixation, and specific sutures are identified risk factors.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Wound Healing Research
Background:
- Congenital pectus excavatum is a chest wall deformity requiring surgical correction.
- The thoracoscopic-assisted Nuss procedure is a common surgical technique for pectus excavatum.
- Postoperative incision healing complications can impact patient outcomes.
Purpose of the Study:
- To identify risk factors associated with poor incision healing in pediatric patients after the Nuss procedure.
- To analyze clinical data to understand predictors of wound complications.
Main Methods:
- Retrospective cohort study analyzing data from 272 children who underwent the Nuss procedure (2017-2024).
- Patients were categorized into good and poor incision healing groups.
- Logistic regression analysis was used to identify independent risk factors.
Main Results:
- 25 out of 272 children experienced poor incision healing.
- Independent risk factors for poor healing included low body mass index (BMI), asymmetric pectus excavatum, history of allergies, wire fixation of Nuss bars, and use of intradermal sutures.
- Statistical significance was observed for all identified risk factors (P < 0.05).
Conclusions:
- Children with low BMI, asymmetric pectus excavatum, and a history of allergies are at higher risk for poor incision healing post-Nuss procedure.
- Intraoperative choices such as wire fixation of bars and intradermal sutures are also linked to increased risk of wound complications.
- These findings can inform surgical strategies to minimize incision healing issues.
Objective:
To investigate the risk factors of postoperative poor incision healing in children with congenital pectus excavatum who underwent thoracoscopic-assisted Nuss procedure.
Methods:
In this study, a retrospective cohort study method was adopted to statistically analyze the clinical data of children with congenital pectus excavatum who underwent thoracoscopic-assisted Nuss procedure from 2017 to 2024. The children were categorized into groups with good incision healing and groups with poor healing according to the criteria, and the risk factors that might affect the incision healing were collected, including gender, age, height, weight, BMI, HI, type of pectus excavatum, and previous allergy history, number of the Nuss bars, whether fixation piece was applied, fixation method, suture method, surgical time and bleeding amount.
Results:
Based on the inclusion and exclusion criteria, a total of 272 children with Nuss procedure were collected, and during the follow-up period, 25 children experienced poor incision healing. Univariate and multivariate logistic regression analyses were performed in both groups, and the results showed that low BMI, asymmetric pectus excavatum, previous allergy history, wire-fixed bars, and intradermal sutures were independent risk factors for poor incisional healing after the Nuss procedure for pectus excavatum (all P < 0.05).
Conclusion:
Poor postoperative incision healing is more likely to occur in children with low BMI, asymmetric pectus excavatum, previous allergy history, and children with intraoperative wire fixation of bars and intradermal sutures.
More Related Videos
Related Concept Videos
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease