A Multicenter Investigation on the Incidence and Risk Factors of Wound Dehiscence Following Surgical Treatment of Metastatic Spinal Tumors: The Korean Society of Spinal Tumors Multicenter Study (KSST 2023-01)

Abstract

Background: Wound dehiscence is a common complication in metastatic spinal tumor surgery, but its risk factors remain unclear. Methods: This retrospective, multicenter study included patients who underwent surgical treatment for metastatic spinal tumors between 2020 and 2022. Data on patient demographics, primary tumor type, comorbidities, laboratory values, surgical details, and the use of radiation therapy, chemotherapy, and steroids were collected. Univariate and multivariate analyses were performed to identify the risk factors associated with wound dehiscence, and survival analysis was conducted based on wound dehiscence. Results: Among the 277 patients included, 32 (11.6%) experienced wound dehiscence, with an average time to onset of 37.1 +/- 24.3 days. Of these patients, 11 patients with wound infections required revision surgery under general anesthesia, whereas 21 patients underwent localized revision surgery. Univariate analysis identified diabetes (p = 0.002), hyperlipidemia (p = 0.026), surgical length (p = 0.008), and preoperative chemotherapy within 30 days before surgery (p = 0.007) as significant risk factors. On multivariate analysis, independent predictors included diabetes (OR: 4.02, 95% CI: 1.66-9.72, p = 0.002), surgical length (OR: 1.25, 95% CI: 1.02-1.52, p = 0.029), and preoperative chemotherapy within 30 days (OR: 3.75, 95% CI: 1.55-9.10, p = 0.003). Preoperative and postoperative radiation therapy did not significantly influence wound dehiscence. Additionally, there was no significant association between wound dehiscence and 90-day mortality or overall survival. Conclusions: This study highlights diabetes, surgical length, and preoperative chemotherapy within 30 days as significant predictors of wound dehiscence following metastatic spinal tumor surgery.