Risk factors associated with wound dehiscence after gynecologic surgeries: A retrospective cohort study

A BSTRACT Objectives: Robust evidence defining independent risk factors for wound dehiscence specifically among gynecologic surgical populations is lacking. Therefore, this study aimed to identify clinical and surgical factors associated with postoperative wound dehiscence in patients undergoing gynecological surgery. Materials and Methods: This retrospective study included 361 patients who underwent abdominal gynecological surgery. Demographic and perioperative data were collected and analyzed. The patients were categorized according to the presence or absence of wound dehiscence. Univariable analyses were performed using the independent t -test and Chi-squared test; variables with P < 0.05 were entered into multivariable logistic regression models to identify independent predictors. Results: Wound dehiscence occurred in 19 (5.3%) patients. Compared with those without dehiscence, affected patients had significantly lower body mass index (BMI) (22.73 ± 4.59 vs. 25.24 ± 5.21), longer operative time (262.3 ± 123.0 vs. 192.8 ± 93.4 min), and prolonged hospital stay (32.95 ± 24.46 vs. 9.24 ± 6.35 days). Wound classification and preoperative infection within 7 days were significantly associated with wound dehiscence. Multivariable analysis identified lower BMI, longer operative time, and preoperative infection within 7 days as independent predictors of wound dehiscence. In subgroup analysis, preoperative infection within 7 days predicted wound dehiscence only in hysterectomy for malignancy, whereas longer operative time was the only predictor in myomectomy or non-malignant procedures. Conclusion: Postoperative wound dehiscence was associated with both patient-related and procedure-related factors in this cohort. Lower BMI, prolonged operative time, and preoperative infection within 7 days were independently associated with increased risk of wound dehiscence. In subgroup analysis, longer operative time may be associated with wound dehiscence in benign cases, whereas preoperative infection within 7 days was associated with wound dehiscence in malignant cases. These findings highlight potentially modifiable perioperative variables that warrant further investigation in prospective studies before clinical recommendations can be established.