IMPACT OF PREOPERATIVE NUTRITIONAL STATUS ON WOUND HEALING OUTCOMES FOLLOWING ELECTIVE ABDOMINAL SURGERY

Background: Wound healing complications remain a common challenge following elective abdominal surgeries, particularly in patients with compromised nutritional status. Malnutrition impairs immune function and tissue regeneration, thereby elevating the risk of postoperative morbidity. Despite this known risk, preoperative nutritional evaluation is not routinely emphasized in clinical practice. Objective: To assess the impact of preoperative nutritional deficiencies on wound healing complications in patients undergoing elective abdominal surgery. Methods: A cross-sectional study was conducted over eight months in three tertiary care hospitals in Lahore, Pakistan. A total of 246 adult patients scheduled for elective abdominal surgery were evaluated. Preoperative nutritional status was assessed using the Subjective Global Assessment (SGA), serum albumin levels, and anthropometric indices. Wound healing outcomes were monitored postoperatively using the Southampton Wound Assessment Scale (SWAS). Statistical analysis was performed using SPSS v26, with chi-square and logistic regression applied to determine associations and predictors. Results: Of the participants, 37.4% were well-nourished, 42.3% moderately malnourished, and 20.3% severely malnourished. Wound complications occurred in 63.6% of moderately and 64% of severely malnourished patients, compared to only 8.7% in well-nourished patients. Hypoalbuminemia (<3.5 g/dL) was significantly associated with higher wound scores (mean SWAS 2.7) and a complication rate of 64.8%. Multivariate analysis confirmed moderate to severe malnutrition and low albumin as independent predictors of wound healing complications (p < 0.01). Conclusion: Preoperative malnutrition and hypoalbuminemia significantly increase the risk of wound complications after elective abdominal surgery. Routine nutritional screening and timely intervention are essential to optimize surgical outcomes and reduce postoperative morbidity.