A prospective study of perioperative factors for wound dehiscence in elective surgeries

Background: Wound dehiscence – the partial or complete separation of surgical wound edges – is a serious post-operative complication causing prolonged hospitalization, increased morbidity, and occasional mortality. Although extensively studied in emergency laparotomies, data on modifiable perioperative risk factors in elective surgery remain limited. Aims and Objectives: The aim of this study was to identify the pre-operative and intraoperative risk factors for wound dehiscence in elective surgeries, and to assess the association of nutritional status, infection, incision type, suture material, and closure technique with its occurrence. Materials and Methods: This prospective observational study enrolled 301 patients aged 18–65 years undergoing elective general surgical procedures at a tertiary care center from July 2024 to February 2026. Perioperative variables were recorded and analyzed against the occurrence of wound dehiscence using the Chi-square, Fisher’s exact, and Student’s t-tests in the Statistical Package for the Social Sciences v21, with P<0.05 considered statistically significant. Results: Wound dehiscence occurred in 17 patients (5.6%). Intraoperative contamination (29.4% vs. 16.2%, P=0.18) and anemia (<11 g/dL; 41.2% vs. 31.0%, P=0.42) were more frequent among patients with dehiscence, and males were over-represented (82.4% vs. 58.5%, P=0.07), but none of these associations reached statistical significance. Hypoalbuminemia (17.6% vs. 37.7%, P=0.12), diabetes mellitus (17.6% vs. 20.4%, P=1.00), operative duration >150 min (29.4% vs. 27.1%, P=0.79), age, incision type, suture material, and closure technique showed no association with wound dehiscence. Conclusion: In this optimized elective surgical cohort, wound dehiscence was uncommon (5.6%) and no single perioperative factorwas independently predictive, suggesting that routine pre-operative correction of anemia, hypoalbuminemia, and hyperglycemia may attenuate the risk conventionally attributed to these factors. Larger studies are needed to confirm the trends observed for intraoperative contamination and male sex.