Effect of Serum Albumin in Wound Healing After Caesarean Section

Hypoalbuminemia, as a marker of malnutrition and disease, is associated with higher risk of poor postoperative outcomes specially wound healing. Serum albumin level less than 3.5 g/dl was associated with increased postoperative morbidity and mortality. Objective of the study was to evaluate the role of serum albumin in wound healing after caesarean section. This cohort study was carried out in the Department of Obstetrics and Gynecology of Dhaka Medical College & Hospital, Bangladesh. A total of 500 pregnant women underwent caesarean section from July 2020 to Dec 2022 were included as per selection criteria. Serum albumin less than 3.5g/dl was considered as hypoalbuminemia. The patients were classified into two groups; Group I women who had serum albumin level <3.5g/dl and Group II serum albumin level 3.5g/dl or more. The wound related complications were monitored with respect to surgical site infection (SSI), wound dehiscence and mortality if any. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-20.0). Hypoalbuminemic (<3.5g/dl) and non hypoalbuminemic (>3.5g/dl) were found 95(19.0%) and 405(81.0%) respectively. It was observed that almost half (44.2%) patients had infection in Group I and 33(8.1%) in Group II. A subject with serum albumin (<3.5) had 8.93 (95.0% CI 5.04 to 15.89) times significantly (p<0.05) increase to developed infection in patients underwent surgery. Serum albumin cut off value of <3.35g/dl with 95.0% sensitivity and 89.0% specificity for prediction of wound infection after surgery. Hypoalbuminemia is an independent risk factor for the delay in wound healing. Nevertheless, low serum albumin level correlates well with the development of surgical site infection contributed to prolonged hospital stay.