Risk factors for impaired surgical wound healing after spinal tuberculosis surgery: a retrospective comparative trial

Objective To investigate the risk factors associated with poor wound healing following surgery for spinal tuberculosis, and to provide a basis for the clinical prevention and management of postoperative wound complications. Methods A retrospective analysis was conducted on the clinical data of 176 patients who underwent surgical treatment for spinal tuberculosis at Shihezi People's Hospital, Xinjiang, between January 2020 and June 2024. Based on wound healing outcomes, patients were divided into a poor healing group ( n = 49) and a good healing group ( n = 127). General patient information, laboratory indicators, and surgery-related data were collected. Univariate analysis and multivariate logistic regression analysis were used to identify independent risk factors for poor wound healing, and a predictive nomogram was constructed. Results Univariate analysis showed that white blood cell (WBC) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), platelet count, hypoalbuminemia, and anemia were significantly different between the two groups ( P < 0.05). Multivariate logistic regression analysis indicated that WBC count [OR = 4.057, 95% CI (1.730–18.043)], CRP [OR = 1.039, 95% CI (1.008–1.075)], and ESR [OR = 1.461, 95% CI (1.199–1.941)] were independent risk factors for poor postoperative wound healing ( P < 0.05). The constructed predictive model demonstrated excellent discriminative ability with an AUC of 0.983, indicating good clinical applicability. Conclusion Preoperative elevation of WBC count, CRP, and ESR are independent risk factors for poor wound healing after spinal tuberculosis surgery. Clinical practice should emphasize preoperative anti-tuberculosis therapy, nutritional support, and close monitoring of inflammatory markers to reduce the risk of wound complications.